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The article report that the guidelines for antiretroviral therapy state that nevirapine pharmacokinetics are not significantly affected by pregnancy, although some pregnant HIV-positive women face an increased risk of fatal liver toxicity, often associated with rash. Although the hepatotoxicity of nevirapine is greater than that of efavirenz, the potential for pregnancy and CD4 cell count-related increased hepatotoxicity is uncertain.

Compares the effectiveness and tolerability of the nonnucleoside reverse transcriptase inhibitors, afavirenz versus nevirapine in all possible indications of current clinical practice. Baseline assessment; Follow-up of efficacy parameters; Tolerability evaluation; Efficacy parameters.

Evaluates the frequency, features, activity and tolerability of combination antiretroviral therapy in HIV-infected patients aged 55 years or older.

Presents a letter to the editor discussing a cross-sectional evaluation assessing the metabolic safety profile of the two available nonnucleoside reverse transcriptase inhibitors (NNRTIs), efavirenz and nevirapine that allowed the identification of 1018 HIV-infected patients treated with highly active antiretroviral therapy (HAART) within twelve months.

Presents a letter to the editor concerning the problems of serum lipid anomalies in the management of HIV-infected patients.

Reports on HIV-infected immigrants from non-European Union countries. Risks of contacting HIV associated with the immigrants; Comparison of epidemiologic, clinical and therapeutic variables among the patients.

Recent studies have reported increased nevirapine hepatotoxicity in female patients with CD4 lymphocyte counts greater than 250 cells/microl (especially pregnant women). However, our open-label comparison of 742 patients treated with either nevirapine or efavirenz-based HAART as naive patients, experienced subjects, or patients on salvage therapy, found no increased hepatotoxicity in nevirapine-treated subjects, in particular with regard to both sex (females versus males) and T-cell-mediated immunodeficiency (CD4 cell counts above versus below 250 cells/microl).

A case of nephrotic syndrome treated with associated cyclophosphamide and corticosteroids came to our attention after over 2 years of self-administered immunosuppressive therapy which remained unchanged and uncontrolled during this period. The self-administered therapy resulted in a severe cell-mediated immunodeficiency (as expressed by a nadir CD4 lymphocyte count of 2 cells/muL). This led to a rapid unfavorable progression of hepatitis B, which was recently acquired and subsequently evolved into a severe cholestatic and fibrosing chronic hepatitis, causing multiple end-organ failure, and ultimately, death. This process was not reversed by lamivudine therapy, hemodialysis, and the use of a Molecular Adsorbent Recirculating System. The role played by repeated drug prescriptions from general practitioners without appropriate clinical and laboratory controls, and that of our patient's depression are discussed. Current literature related to the presented case and the ongoing debate regarding repeated prescriptions are considered in this study.

Pleiotropic features are attributed to statins and fibrates, and effects on laboratory markers of HIV disease progression have been claimed. To assess whether statins/fibrates have long-term effects on the immune recovery of patients on virologically effective HAART, a prospective, comparative study was conducted on 267 dyslipidemic patients treated with either statins, fibrates, or on a dietary exercise programme only. Quarterly assessment of CD4 cell counts showed no differences between groups, thus excluding in-vivo negative immunological effects during effective HAART.

Sixteen HIV-infected patients with protease inhibitor (PI)-related, persisting hypercholesterolaemia were treated with 10 mg a day rosuvastatin for 24 weeks. At the end of the observation period, the median reductions in total cholesterol and triglyceride levels versus median baseline values were 21.7 and 30.1%, respectively (P < 0.01). In our small pilot study, rosuvastatin was found to be effective for the treatment of PI-associated hyperlipidaemia, in association with a favourable tolerability profile, without significant clinical or laboratory adverse events.

Ninety-seven consecutive patients started anti-HIV therapy based on efavirenz (46) or lopinavir-ritonavir (51) in an observational study. Despite the significantly more compromised immunological-clinical baseline conditions of patients starting lopinavir-ritonavir, a mean clinical-laboratory follow-up of 17 months showed a comparable laboratory response and therapy interruption or change rate, although the toxicity profile of the two compounds proved significantly different. Randomized studies comparing these two recommended first-line treatments are warranted, particularly from a pharmacoeconomic viewpoint.