Nevirapine: new preparation. In second-line triple-drug anti-HIV regimens

(1) Nevirapine is the first non nucleoside inhibitor of HIV-1 reverse transcriptase to be marketed in France. (2) The clinical file comprises three comparative double-blind trials. One showed a better clinical benefit (in terms of disease progression or death) of a three-drug regimen comprising zidovudine, didanosine and nevirapine than with zidovudine + didanosine bitherapy. Two trials focusing on laboratory criteria (viral load and the CD4+ cell count) showed that a three-drug regimen of zidovudine + didanosine + nevirapine was more effective, after 12 months of treatment, than bitherapy with zidovudine + nevirapine or zidovudine + didanosine. (3) Occasionally severe cutaneous reactions are the main adverse effects of nevirapine. (4) Nevirapine is a liver enzyme inducer, hence the possibility of drug interactions, especially with protease inhibitors of HIV; the clinical consequences are poorly known.