Cochrane · systematic review · CD004246
Efavirenz or nevirapine in three‐drug combination therapy with two nucleoside or nucleotide‐reverse transcriptase inhibitors for initial treatment of HIV infection in antiretroviral‐naïve individuals
Mbuagbaw, L, Mursleen, S, Irlam, JH, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
19
current version
GRADE rated
19
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 5.3%Low 6 · 31.6%Moderate 9 · 47.4%High 3 · 15.8%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version only'Summary of findings' table 1
Population: antiretroviral‐naïve individuals
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Virological success | RR 1.04 [0.99, 1.09] | 10 studies · 2438 participants | High |
Mortality | RR 0.84 [0.59, 1.19] | 8 studies · 2317 participants | Moderate Downgraded: imprecision |
Progression to AIDS | RR 1.23 [0.72, 2.11] | 5 studies · 2005 participants | Moderate Downgraded: imprecision |
All severe adverse events | RR 0.91 [0.71, 1.18] | 8 studies · 2329 participants | Very low Downgraded: imprecision |
Discontinuation rate | RR 0.93 [0.69, 1.25] | 9 studies · 2384 participants | Moderate Downgraded: imprecision |
Change in CD4 count | no estimate extracted | 9 studies · 1829 participants | Moderate Downgraded: risk of bias, imprecision |
Treatment failure | RR 0.97 [0.76, 1.24] | 5 studies · 737 participants | Low |
'Summary of findings' table 2
Population: antiretroviral‐naïve individuals
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Severe adverse events: central nervous system | RR 4.46 [1.65, 12.03] | 6 studies · 2049 participants | Moderate Downgraded: risk of bias |
Severe adverse events: gastrointestinal | RR 0.76 [0.48, 1.21] | 6 studies · 2049 participants | Low Downgraded: risk of bias, imprecision |
Severe adverse events: pyrexia | RR 0.65 [0.15, 2.73] | 3 studies · 1799 participants | Low Downgraded: imprecision |
Severe adverse events: raised transaminases | RR 0.52 [0.35, 0.78] | 3 studies · 1299 participants | High |
Severe adverse events: raised alkaline phosphatase | RR 0.65 [0.17, 2.5] | 1 study · 1007 participants | Low Downgraded: imprecision |
Severe adverse events: raised amylase | RR 1.4 [0.72, 2.73] | 2 studies · 1071 participants | Low Downgraded: imprecision |
Severe adverse events: raised triglycerides | RR 1.1 [0.39, 3.13] | 2 studies · 1071 participants | Low Downgraded: imprecision |
Severe adverse events: neutropenia | RR 0.48 [0.28, 0.82] | 3 studies · 1799 participants | High |
Severe adverse events: rash | RR 0.58 [0.34, 1] | 7 studies · 2277 participants | Moderate Downgraded: imprecision |
Severe adverse events: serum glutamic oxaloacetic transaminase (SGOT) | no estimate extracted | 1 study · 135 participants | Moderate Downgraded: imprecision |
Severe adverse events: serum glutamic‐ pyruvic transaminase (SGPT) | no estimate extracted | 1 study · 135 participants | Moderate Downgraded: imprecision |
Raised cholesterol | RR 6.03 [0.75, 48.78] | 1 study · 64 participants | Moderate Downgraded: imprecision |
Efavirenz 600mg versus Nevirapine 200mg twice daily for initial treatment of HIV infection in antiretroviral‐naive individuals
Population: patients with initial treatment of HIV infection in antiretroviral‐naive individuals
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Virological success Efavirenz 600mg vs Nevirapine 200mg twice daily | RR 1.02 [0.95, 1.1] | 4 studies · 1200 participants | High |
Change in CD4 count Efavirenz 600mg vs Nevirapine 200mg twice daily | no estimate extracted | 5 studies · 1285 participants | High |
Mortality Efavirenz 600mg vs Nevirapine 200mg twice daily | RR 0.89 [0.5, 1.57] | 4 studies · 1215 participants | Moderate Downgraded: indirectness |
Progression to AIDS Efavirenz 600mg vs Nevirapine 200mg twice daily | RR 1.32 [0.53, 3.3] | 4 studies · 1215 participants | Moderate Downgraded: indirectness |
Discontinuation rate Efavirenz 600mg vs Nevirapine 200mg twice daily | RR 0.94 [0.72, 1.22] | 4 studies · 1215 participants | Moderate Downgraded: indirectness |
All severe adverse events Efavirenz 600mg vs Nevirapine 200mg twice daily | RR 1.01 [0.6, 1.7] | 4 studies · 1054 participants | Moderate Downgraded: indirectness |
Efavirenz 600mg versus Nevirapine 400mg once daily for initial treatment of HIV infection in antiretroviral‐naive individuals
Population: patients with initial treatment of HIV infection in antiretroviral‐naive individuals
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Virological success Efavirenz 600mg vs Nevirapine 400mg once daily | RR 1.11 [0.94, 1.31] | 3 studies · 803 participants | High |
Change in CD4 count Efavirenz 600mg vs Nevirapine 400mg once daily | no estimate extracted | 2 studies · 687 participants | High |
Mortality Efavirenz 600mg vs Nevirapine 400mg once daily | RR 0.41 [0.18, 0.94] | 3 studies · 878 participants | Moderate Downgraded: indirectness |
Progression to AIDS Efavirenz 600mg vs Nevirapine 400mg once daily | RR 0.79 [0.3, 2.04] | 1 study · 620 participants | Moderate Downgraded: indirectness |
Discontinuation rate Efavirenz 600mg vs Nevirapine 400mg once daily | RR 1.48 [1.15, 1.9] | 2 studies · 674 participants | Moderate Downgraded: indirectness |
All severe adverse events Efavirenz 600mg vs Nevirapine 400mg once daily | RR 1.34 [0.93, 1.91] | 3 studies · 803 participants | Moderate Downgraded: indirectness |