Factors to consider: depression and CNS

  • EFV is associated with:1
    • Significantly increased levels of stress
    • Trend towards increased total depression scores
    • Trend towards increased levels of anxiety
  • Incidence of CNS effects higher in those prior history of psychiatric disorders (57% vs. 47%)2
  • Those without prior history of psychiatric disorders tend to tolerate NSS effects better2
  • Important to recognise & treat psychiatric disorders before starting EFV therapy2
case didier graph 2

1. Adapted from: Rihs TA et al. HIV Med 2006;7:544–548 2. Cohen CJ & Kessler HA. http://www.medscape.com/viewprogram/2859_pnt


Factors to consider: resistance with first-generation NNRTIs

1. Weinstock HS, et al. J Infect Dis 2004;189:2174-80. 2. Guidelines for the use of antiretroviral agents in HIV-infected adults and adolescents, 2006: http://AIDSinfo.nih.gov. 3. Wensing AM, et al. J Infect Dis 2005;192:958-66. 4. Novak RM, et al. Clin Infect Dis 2005;40:468-74. 5. Von Wyl V, et al. Arch Intern Med 2007;167:1782-90.


Factors to consider: genetic barrier to the development of resistance

case didier graph 3

1. Antinori A, et al. AIDS Res Hum Retroviruses 2002;18:835-8.
2. Lecossier D, et al. J Acquir Immune Defic Syndr 2005;38:37-42.
3. Vingerhoets J, et al. IV EHDRW, 2006.
4. Bertoli A, et al. IV EHDRW, 2006.
5. de Mendoza C, et al. HIV Clin Trials 2006;7:163-71.