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Practice Guideline
. 2019 Oct;106(4):726-733.
doi: 10.1002/cpt.1477. Epub 2019 Jul 5.

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2B6 and Efavirenz-Containing Antiretroviral Therapy

Zeruesenay Desta  1 , Roseann S Gammal  2   3 , Li Gong  4 , Michelle Whirl-Carrillo  4 , Aditya H Gaur  5 , Chonlaphat Sukasem  6   7 , Jennifer Hockings  8 , Alan Myers  9 , Marelize Swart  1 , Rachel F Tyndale  10 , Collen Masimirembwa  11 , Otito F Iwuchukwu  12 , Sanika Chirwa  13 , Jeffrey Lennox  14 , Andrea Gaedigk  15 , Teri E Klein  4 , David W Haas  13   16
Affiliations
Practice Guideline

Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2B6 and Efavirenz-Containing Antiretroviral Therapy

Zeruesenay Desta et al. Clin Pharmacol Ther. 2019 Oct.

Abstract

The HIV type-1 nonnucleoside reverse transcriptase inhibitor, efavirenz, is widely used to treat HIV type-1 infection. Efavirenz is predominantly metabolized into inactive metabolites by cytochrome P450 (CYP)2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse effects, particularly central nervous system toxicity and treatment discontinuation. We summarize the evidence from the literature and provide therapeutic recommendations for efavirenz prescribing based on CYP2B6 genotypes.

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Conflict of interest statement

Conflicts of Interest:

As an Associate Editor for Clinical Pharmacology & Therapeutics, Rachel Tyndale was not involved in the review or decision process for this paper. All other authors declared no competing interests for this work.

Figures

Figure 1
Figure 1
Schematic representation of efavirenz metabolism and mechanism of action against HIV (12, 14) An interactive version of the pathway is available at: https://www.pharmgkb.org/pathway/PA166123135). Image reproduced and is licensed under CC BY-SA 4.0 from PharmGKB.
See this image and copyright information in PMC

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