Search results for "EFAVIRENZ"
showing 10 items of 34 documents
Twenty Years of HIV-1 Non-Nucleoside Reverse Transcriptase Inhibitors: Time to Reevaluate their Toxicity
2011
Twenty years of effective clinical application have consolidated non-nucleoside reverse transcriptase inhibitors (NNRTI) as essential components of the Highly Active Antiretroviral Therapy (HAART) employed in the treatment of Human Immunodeficiency Virus (HIV). However, as the disease has come under control, there has been growing emphasis on the long-term adverse effects induced by this chronic pharmacological therapy. Although traditionally considered to be safe and well-tolerated drugs, there is mounting evidence that associates NNRTI with the onset of cutaneous reactions, neuropsychiatric symptoms, hepatotoxicity, metabolic disturbances and gastrointestinal toxicity. Though the clinical…
Future Perspectives in NNRTI-Based Therapy: Bases for Understanding Their Toxicity
2011
Continuous administration of the drugs included under the term Highly Active Antiretroviral Therapy (HAART) has turned AIDS into a chronic disease, at least in developed countries (Panos et al., 2008). The initial development of these drugs was particularly rapid and focused on clinical efficacy before all other considerations. However, as the disease has come under control, there has been growing emphasis on the long-term adverse effects associated with this therapy. The first drug for the treatment of HIV infection, zidovudine (AZT), was approved in 1987. The number of other antiretroviral drugs already approved for use or under development continues to grow, and the primary aim of resear…
Efavirenz induce una respuesta diferencial en la bioenergética y función mitocondrial de neuronas y células gliales
2014
Efavirenz (EFV) es el inhibidor de la transcriptasa inversa no análogos de nucleósidos (ITINAN) más ampliamente utilizado en el tratamiento de la infección por el VIH. Durante muchos años ha contribuido significativamente a la evolución de la terapia antirretroviral de gran actividad (TARGA) y a pesar de ser considerado un fármaco seguro y bien tolerado, existe una creciente preocupación debido a que los regímenes que lo contienen han sido asociados con efectos adversos, siendo los trastornos neuropsiquiátricos la reacción adversa más notable y un factor de riesgo para el fracaso de la terapia. Los mecanismos responsables no han sido caracterizados, aunque algunos trabajos recientes vincula…
Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe
2016
Transmitted human immunodeficiency virus drug resistance in Europe is stable at around 8%. The impact of baseline mutation patterns on susceptibility to antiretroviral drugs should be addressed using clinical guidelines. The impact on baseline susceptibility is largest for nonnucleoside reverse transcriptase inhibitors.
Efavirenz alters mitochondrial respiratory function in cultured neuron and glial cell lines.
2015
Abstract Background The NNRTI efavirenz is among the most widely employed antiretroviral drugs. Although it is considered safe, efavirenz has been linked with several adverse effects including neurological manifestations, which appear in the majority of the patients on efavirenz-containing regimens. The molecular mechanisms responsible for these manifestations are not understood, but mounting evidence points to altered brain bioenergetics. Methods We evaluated the effect of short-term efavirenz treatment on the mitochondrial respiratory function of cultured glioblastoma and differentiated neuroblastoma cell lines using a Seahorse Extracellular Flux Analyzer. Results Incubation with efaviren…
Lack of mitochondrial toxicity of darunavir, raltegravir and rilpivirine in neurons and hepatocytes: a comparison with efavirenz.
2014
Objectives Growing evidence associates the non-nucleoside reverse transcriptase inhibitor efavirenz with several adverse events. Newer antiretrovirals, such as the integrase inhibitor raltegravir, the non-nucleoside reverse transcriptase inhibitor rilpivirine and the protease inhibitor darunavir, claim to have a better toxicological profile than efavirenz while producing similar levels of efficacy and virological suppression. The objective of this study was to determine the in vitro toxicological profile of these three new antiretrovirals by evaluating their effects on the mitochondrial and cellular parameters altered by efavirenz in hepatocytes and neurons. Methods Hep3B cells and primary …
Efavirenz and the CNS: what we already know and questions that need to be answered
2015
The NNRTI efavirenz has long been one of the most frequently employed antiretroviral drugs in the multidrug regimens used to treat HIV infection, in accordance with its well-demonstrated antiretroviral efficacy and favourable pharmacokinetics. However, growing concern about its adverse effects has sometimes led to efavirenz being replaced by other drugs in the initial treatment selection or to switching of therapy to efavirenz-free regimens in experienced patients. Neurological and neuropsychiatric reactions are the manifestations most frequently experienced by efavirenz-treated patients and range from transitory effects, such as nightmares, dizziness, insomnia, nervousness and lack of conc…
Mitochondrial (dys)function - a factor underlying the variability of efavirenz-induced hepatotoxicity?
2015
Background and Purpose The non-nucleoside analogue reverse transcriptase inhibitor efavirenz is associated with hepatic toxicity and metabolic disturbances. Although the mechanisms involved are not clear, recent evidence has pinpointed a specific mitochondrial action of efavirenz accompanied by the induction of an endoplasmic reticulum (ER) stress/unfolded protein response in human hepatic cells. The aim of this study was to further investigate the involvement of this organelle by evaluating efavirenz's effects in cells lacking functional mitochondria (rho°) and comparing them with those of the typical mitotoxic agent rotenone, a standard complex I inhibitor, and the ER stress inducer thaps…
Papel central de la mitocondria en la hepatotoxicidad inducida por Efavirenz
2013
La toxicidad hepática y los desordenes metabólicos son los principales efectos adversos asociados al tratamiento farmacológico de la infección con el virus de la inmunodeficiencia humana (VIH). El Efavirenz (EFV) es el miembro de la familia de los inhibidores de la transcriptasa inversa no análogos de nucleósidos (ITINAN) más ampliamente utilizado en el tratamiento del VIH. Su uso ha sido asociado con el desarrollo de diversos efectos adversos, entre ellos la hepatotoxicidad, pero los mecanismos celulares y moleculares responsables de su aparición aún no han sido caracterizados, aunque algunos trabajos recientes vinculan su toxicidad con disfunción mitocondrial. En esta tesis, describimos u…
Mitochondria and endoplasmic reticulum interplay at the core of efavirenz-induced hepatic effects
2016
El inhibidor de la transcriptasa inversa no análogo de nucleósido efavirenz (EFV) es uno de los fármacos más utilizados en la terapia antirretroviral combinada (TARc) empleada en el tratamiento de la infección por el virus de la inmunodeficiencia humana (VIH). Aunque en general se ha considerado seguro, existe una gran preocupación acerca de los efectos secundarios inducidos por las terapias que contienen EFV. Este fármaco se ha asociado con toxicidad hepática y trastornos metabólicos y, aunque los mecanismos implicados no están claros, evidencias recientes han señalado una acción mitocondrial específica de EFV acompañada por la inducción de estrés de retículo endoplasmático (RE)/respuesta …