presence of the cyp2b6 516g t polymorphism, increased plasma efavirenz concentrations and early neuropsychiatric side effects in south african hiv-infected patientscyp2b6 516 g t多态性,增加依法韦伦血浆浓度和早期神经副作用在南非艾滋病病毒感染者.pdfVIP
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presence of the cyp2b6 516g t polymorphism, increased plasma efavirenz concentrations and early neuropsychiatric side effects in south african hiv-infected patientscyp2b6 516 g t多态性,增加依法韦伦血浆浓度和早期神经副作用在南非艾滋病病毒感染者
Gounden et al. AIDS Research and Therapy 2010, 7:32
/content/7/1/32
RESEARCH Open Access
Presence of the CYP2B6 516G T polymorphism,
increased plasma Efavirenz concentrations and
early neuropsychiatric side effects in South
African HIV-infected patients
Verena Gounden 1,2*, Chantal van Niekerk1,2, Tracy Snyman1,2, Jaya A George1,2
Abstract
Background: The 516G T polymorphism in exon 4 of the CYP2B6 gene has been associated with increased
plasma Efavirenz (EFV) concentrations. EFV concentrations greater than the recommended therapeutic range have
been associated with the increased likelihood of developing adverse CNS effects. The aims of this study were to a)
determine the presence of the 516G T and other CYP2B6 exon 4 polymorphisms in a South African group of HIV-
infected individuals b) investigate the relationship between the EFV plasma concentrations, the CYP2B6 516G T
polymorphism and the occurrence of CNS related side effects in this group of patients and c) develop and validate
a rapid method for determination of EFV in plasma.
Method: Data from 80 patients is presented. Genetic polymorphisms in exon 4 of the CYP2B6 gene were identified
using PCR amplification of this region followed by sequencing of the amplification products. EFV concentrations
were analysed by UPLC-MS/MS. Assessment of the presence of CNS related side effects following EFV initiation
were elicited with the use of a questionnaire together with physical examination.
Results: Plasma EFV concentrations displayed high inter-individual variability amongst subjects with concentrations
ranging from 94 μg/l to 23227 μg/l at 2 weeks post initiation of treatment. For the 516G T polymorphism the
following frequencies were observed 23% of patients were TT homozygous, 36% GG and 41% GT. The TT
homozygous patients had significantly higher
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