Efavirenz and the CNS: what we already know and questions that need to be answered
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Altres documents de l'autoria: Apostolova, Nadezda; Funes, Haryes A.; Blas García, Ana; Galindo, Maria J.; Álvarez, Ángeles; Esplugues, Juan V.
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Efavirenz and the CNS: what we already know and questions that need to be answeredAutoria
Data de publicació
2015-07Editor
Oxford University PressCita bibliogràfica
APOSTOLOVA, Nadezda, et al. Efavirenz and the CNS: what we already know and questions that need to be answered. Journal of Antimicrobial Chemotherapy, 2015, vol. 70, no 10, p. 2693-2708.Tipus de document
info:eu-repo/semantics/articleVersió de l'editorial
http://jac.oxfordjournals.org/content/70/10/2693.shortVersió
info:eu-repo/semantics/publishedVersionResum
The NNRTI efavirenz has long been one of the most frequently employed antiretroviral drugs in the multidrug
regimens used to treat HIV infection, in accordance with its well-demonstrated antiretroviral efficacy and ... [+]
The NNRTI efavirenz has long been one of the most frequently employed antiretroviral drugs in the multidrug
regimens used to treat HIV infection, in accordance with its well-demonstrated antiretroviral efficacy and favourable
pharmacokinetics. However, growing concern about its adverse effects has sometimes led to efavirenz being
replaced by other drugs in the initial treatment selection or to switching of therapy to efavirenz-free regimens in
experienced patients. Neurological and neuropsychiatric reactions are the manifestations most frequently experienced
by efavirenz-treated patients and range from transitory effects, such as nightmares, dizziness, insomnia,
nervousness and lack of concentration, to more severe symptoms including depression, suicidal ideation or even
psychosis. In addition, efavirenz has recently been associated with mild/moderate neurocognitive impairment,
which is of specific relevance given that half of the patients receiving ART eventually suffer some form of HIVassociated
neurocognitive disorder. The mechanisms responsible for efavirenz-induced neurotoxicity are unclear,
although growing evidence points to disturbances in brain mitochondrial function and bioenergetics. This review
offers a comprehensive overview of the current evidence on the interaction that efavirenz displays with the CNS,
including the penetration and concentration of the drug in the brain. We discuss the prevalence, types and
specificities of its side effects and recently uncovered cellular mechanisms that may be involved in their
development. [-]
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Journal of Antimicrobial Chemotherapy, 2015, vol. 70, no 10Drets d'accés
© The Author 2015. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com
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