Nevirapine pharmacokinetics in HIV-infected and HIV/HCV-coinfected individuals

An increased risk of drug-related liver injury has been repeatedly reported in individuals infected with hepatitis C virus (HCV) receiving the antiretroviral drug nevirapine. This study was undertaken to assess the differences in the pharmacokinetics of nevirapine between patients with HIV/HCV coinfection and HIV infection that could explain higher rates of hepatotoxicity. A 12 h pharmacokinetic analysis was performed in 18 patients: 7 HIV/HCV-coinfected and 11 HIV-monoinfected. Advanced liver disease was an exclusion criterion in order to assess the impact of chronic HCV infection alone. Comparing the two groups, no difference was observed between minimum and maximum drug levels or total drug exposure in terms of area under the curve. Hepatitis C coinfection does not alter the pharmacokinetics of nevirapine in patients with preserved liver function.