A Thai researcher is bringing much-needed attention to the link between CYP2B6 polymorphisms and plasma efavirenz concentrations in HIV-positive Thais.
“If the level of plasma efavirenz is too low, patients won’t find the treatment effective. If the level is too high, the medicine may be toxic to a patient’s nervous system,” Asst Prof Chonlaphat Sukasem said yesterday.
Low plasma efavirenz concentrations also pose a risk that HIV would mutate and turn resistant to available basic drugs like efavirenz, said Chonlaphat, a researcher at Mahidol University’s Medical School at Ramathibodi Hospital.
The research, whose findings have been published in an international journal, was funded by the Thailand Research Fund, the Higher Education Commission and Mahidol University, and the Science Ministry.
The National Health Security Office should consider allowing CYP2B6 checks and tests of plasma efavirenz levels for patients.
“Then, the efavirenz dose can be adjusted accordingly,” he said.
The Government Pharmaceutical Organisation should offer more sizes of Efavirenz tablets than just the standard 600 milligrams so that doctors can easily prescribe doses.
“Some patients may need just 400mg while some may need 800mg of efavirenz,” he said.