Coverage of CROI 2008 (Conference on Retroviruses and Opportunistic Infections)

February 4–6, 2008, Boston, MA

Viramune: maybe twice a day, maybe once a day

February 5, 2008

A poster presented at CROI found that Viramune (nevirapine) given once a day was as safe as when given twice a day for people on stable twice-a-day Viramune regimens. This study looked at just over 300 people in Spain who had been on twice-a-day Viramune regimens for at least 8 weeks (12 weeks for women with CD4 counts above 250), undetectable levels of HIV, and no signs of liver trouble. Half were randomly switched to once-a-day Viramune and half stayed on twice-a-day regimens.

Overall there were low levels of liver problems in the study. There were more cases of liver problems among people taking once-a-day Viramune, but the difference was mostly due to people with viral hepatitis. There were no significant differences between the groups in terms of maintaining undetectable HIV.

Viramune is the second most widely used NNRTI, lagging well behind Sustiva (efavirenz). The biggest concern with Viramune is the risk of catastrophic liver toxicity, especially in women and people with higher CD4 counts. Viramune was approved for taking twice a day but has been widely used once a day, because of its ability to stay in the body for a long time. This study suggests that people who already take Viramune successfully—meaning they have undetectable HIV and no signs of liver problems—can take it either once or twice a day.