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SIDE effects associated with use of nevirapine in HIV treatment naïve patients with respect to baseline CD4 count


This study aims to detect Nevirapine (NVP) side effects among patients started with lead in dose at initiation of Anti Retroviral Therapy (ART) with CD4 count >250 cells/mm3 in female and CD4 count >400 cells/mm3 in male.


Close monitoring was conducted for the detection of NVP based side effects among ART - naïve patients initiated on CD4 count >250 cells/mm3 among women and CD4 count > 400 cells/mm3 are the study target at Centre of Excellence (CoE), ART Centre, B. J. Medical College, Civil Hospital, Ahmedabad, Gujarat, India.


Total 5060 patients were initiated ART during the period of may 2005 to may 2009 at the institute. Among this 3647 (72%) were initiated with NVP lead in dose as per the Indian National ART Guidelines, Table 1.

Table 1


Skin Rash was recovered on substituting with another NNRTI- Efavirenz (EFV) and the treatment was well tolerated. Hepatitis was managed with substitution to EFV and close follow-up on ALT and AST. Though western literature has a black box warning for use of NVP, this data shows if closely monitored it could be given at resources limited settings with CD4 counts >250 cells/mm3 in females and >400 cells/mm3 males. Nevirapine is cost effective molecule compared to Efavirenz and when given in such conditions of higher CD4 need close follow up.

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Correspondence to Manoj Shevkani.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Shevkani, M., Mankad, B., Rathod, G. et al. SIDE effects associated with use of nevirapine in HIV treatment naïve patients with respect to baseline CD4 count. Retrovirology 7 (Suppl 1), O14 (2010).

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  • Hepatitis
  • Limited Setting
  • Skin Rash
  • Efavirenz
  • Nevirapine