Updated
Reviewed
Apr. 07, 2021

Management of Medication Toxicity or Intolerance

CNS Toxicity

Table 15a. Antiretroviral Therapy-Associated Adverse Effects and Management Recommendations—Central Nervous System Toxicity
Table 15a. Antiretroviral Therapy-Associated Adverse Effects and Management Recommendations—Central Nervous System Toxicity
   
   
   
   

References

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  2. Capetti AF, Di Giambenedetto S, Latini A, et al. Morning dosing for dolutegravir-related insomnia and sleep disorders. HIV Med. 2018;19(5):e62-e63. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28762661.
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  7. Fettiplace A, Stainsby C, Winston A, et al. Psychiatric symptoms in patients receiving dolutegravir. J Acquir Immune Defic Syndr. 2017;74(4):423-431. Available at: https://www.ncbi.nlm.nih.gov/pubmed/27984559.
  8. Food and Drug Administration. FDA drug safety communication: serious health problems seen in premature babies given kaletra (lopinavir/ritonavir) oral solution. 2011. Available at: https://www.fda.gov/Drugs/DrugSafety/ucm246002.htm.
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  18. Madeddu G, Menzaghi B, Ricci E, et al. Raltegravir central nervous system tolerability in clinical practice: results from a multicenter observational study. AIDS. 2012;26(18):2412-2415. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23032413.
  19. Mills A, Garner W, Pozniak A, et al. Patient-reported symptoms over 48 weeks in a randomized, open-label, Phase IIIb non-inferiority trial of adults with HIV switching to co-formulated elvitegravir, cobicistat, emtricitabine, and tenofovir DF versus continuation of non-nucleoside reverse transcriptase inhibitor with emtricitabine and tenofovir DF. Patient. 2015;8(4):359-371. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26045359.
  20. Mollan KR, Smurzynski M, Eron JJ, et al. Association between efavirenz as initial therapy for HIV-1 infection and increased risk for suicidal ideation or attempted or completed suicide: an analysis of trial data. Ann Intern Med. 2014;161(1):1-10. Available at: https://www.ncbi.nlm.nih.gov/pubmed/24979445.
  21. Mollan KR, Tierney C, Hellwege JN, et al. Race/ethnicity and the pharmacogenetics of reported suicidality with efavirenz among clinical trials participants. J Infect Dis. 2017;216(5):554-564. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28931220.
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  25. Pinillos F, Dandara C, Swart M, et al. Case report: severe central nervous system manifestations associated with aberrant efavirenz metabolism in children: the role of CYP2B6 genetic variation. BMC Infect Dis. 2016;16:56. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26831894.
  26. Puthanakit T, Tanpaiboon P, Aurpibul L, Cressey TR, Sirisanthana V. Plasma efavirenz concentrations and the association with CYP2B6-516G >T polymorphism in HIV-infected Thai children. Antivir Ther. 2009;14(3):315-320. Available at: https://www.ncbi.nlm.nih.gov/pubmed/19474465.
  27. Reiss KA, Bailey JR, Pham PA, Gallant JE. Raltegravir-induced cerebellar ataxia. AIDS. 2010;24(17):2757. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20980871.
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  29. Smith C, Ryom L, dʼArminio Monforte, et al. Lack of association between use of efavirenz and death from suicide: evidence from the D:A:D study. J Int AIDS Soc. 2014;17(4 Suppl 3):19512. Available at: https://www.ncbi.nlm.nih.gov/pubmed/25394021.
  30. Strehlau R, Martens L, Coovadia A, et al. Absence seizures associated with efavirenz initiation. Pediatr Infect Dis J. 2011;30(11):1001-1003. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21633320.
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  32. Van de Wijer L, McHaile DN, de Mast Q, et al. Neuropsychiatric symptoms in Tanzanian HIV-infected children receiving long-term efavirenz treatment: a multicentre, cross-sectional, observational study. Lancet HIV. 2019;6(4):e250-e258. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30770324.
  33. van Dijk JH, Sutcliffe CG, Hamangaba F, Bositis C, Watson DC, Moss WJ. Effectiveness of efavirenz-based regimens in young HIV-infected children treated for tuberculosis: a treatment option for resource-limited settings. PLoS One. 2013;8(1):e55111. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23372824.
  34. Variava E, Sigauke FR, Norman J, et al. Brief report: late efavirenz-induced ataxia and encephalopathy: a case series. J Acquir Immune Defic Syndr. 2017;75(5):577-579. Available at: https://www.ncbi.nlm.nih.gov/pubmed/28520619.
  35. Waalewijn H, Turkova A, Rakhmanina N, et al. Optimizing pediatric dosing recommendations and treatment management of antiretroviral drugs using therapeutic drug monitoring data in children living with HIV. Ther Drug Monit. 2019;41(4):431-443. Available at: https://www.ncbi.nlm.nih.gov/pubmed/31008997.
  36. Walmsley S, Baumgarten A, Berenguer J, et al. Brief report: dolutegravir plus abacavir/lamivudine for the treatment of HIV-1 infection in antiretroviral therapy-naive patients: week 96 and week 144 results from the SINGLE randomized clinical trial. J Acquir Immune Defic Syndr. 2015;70(5):515-519. Available at: https://www.ncbi.nlm.nih.gov/pubmed/26262777.
  37. Waters L, Fisher M, Winston A, et al. A Phase IV, double-blind, multicentre, randomized, placebo-controlled, pilot study to assess the feasibility of switching individuals receiving efavirenz with continuing central nervous system adverse events to etravirine. AIDS. 2011;25(1):65-71. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21099666.

Management of Medication Toxicity or Intolerance

CNS Toxicity

Table 15a. Antiretroviral Therapy-Associated Adverse Effects and Management Recommendations—Central Nervous System Toxicity
Table 15a. Antiretroviral Therapy-Associated Adverse Effects and Management Recommendations—Central Nervous System Toxicity
   
   
   
   

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