Nevirapine Tolerance Induction Safe, Effective

Allergic reactions to the antiretroviral agent nevirapine can be prevented in high-risk patients, researchers in France report. "The most frequent side-effects due to nevirapine (Viramune), the first non-nucleoside HIV reverse transcriptase inhibitor introduced for clinical use, are cutaneous hypersensitivity reactions," explained Djamel Messaad and colleagues at Arnaud de Villeneuve Hospital, Montpellier University Hospital and Gui de Chauliac Hospital in Montpellier. Tolerance can be safely, rapidly, and durably induced in patients with limited treatment options who experience such reactions, the researchers found.

A group of six HIV patients with a history of allergic reactions to nevirapine were administered increasing doses of the agent every half-hour over a six-hour period. Nevirapine doses were increased from the initial 2.5 7g to a final dose of 100 mg during this time, Messaad and coauthors said. Five of the six study participants were subsequently able to receive nevirapine therapy without complications for at least three months, study data showed. One patient discontinued nevirapine treatment after one month due to a resumption of hypersensitivity reactions.

In addition, one of the successfully treated patients reported a "mild and transient" allergic reaction immediately after the tolerance induction regimen ("Long-Term Safety And Efficacy Of Nevirapine Tolerance Induction," Clinical and Experimental Allergy, (2002;32(5):733-735).

"Therefore, when no alternatives are available in severely ill and hypersensitive HIV-infected patients, tolerance induction is a possible therapeutic option," Messaad and colleagues concluded.

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