Tolerance of a Short Course of Nevirapine, Associated With 2 Nucleoside Analogues, in Postexposure Prophylaxis of HIV

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Abstract
A combination of 2 nucleoside analogues and 1 protease inhibitor is usually recommended in postexposure prophylaxis. Because of the complex treatment schedule and frequent adverse effects, however, this regimen is often not completed. Therefore, since January 2000, we have used nevirapine (NVP), 200 mg/d, for only 4 days in combination with 2 nucleoside analogues for 1 month to improve adherence and completion rates. We present a 2-year retrospective analysis on 120 individuals who received this prophylaxis. Only 2 subjects stopped NVP because of a clinical event, whereas 10 interrupted the nucleoside analogues. We observed 3 (2.8%) of 104 slight alanine aminotransferase (ALT) increases in the first 2 weeks of treatment (grade 1). Three additional (month 1 or 3) ALT augmentations also occurred (also grade 1). No HIV or hepatitis C virus seroconversion occurred during follow-up. Twenty-nine (38.2%) of 76 individuals and 21 (47.7%) of 44 individuals were seen 3 months after nonoccupational and occupational exposure, respectively. We believe that such a short course (4 days) of 200-mg NVP treatment once a day in combination with 2 nucleoside analogues for 1 month is clinically and biologically safe.