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However, the high rate of central nervous system (CNS) toxicities from <jats:styled-content style=\"fixed-case\">EFV<\/jats:styled-content> prompted the U.S. Department of Health and Human Services to move the <jats:styled-content style=\"fixed-case\">EFV<\/jats:styled-content>\u2010based regimen from the recommended to the alternative category. For patients who do meet the criteria for newer recommended antiretroviral treatments, <jats:styled-content style=\"fixed-case\">EFV<\/jats:styled-content> is a viable option and often the mainstay of treatment outside the United States because newer antiretroviral treatments are more expensive. CNS toxicity occurring with the recommended standard dose of <jats:styled-content style=\"fixed-case\">EFV<\/jats:styled-content> remains a challenge and may in part be attributable to polymorphisms in cytochrome P450 (<jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>) 2B6, the enzyme involved in the major metabolic pathway for converting <jats:styled-content style=\"fixed-case\">EFV<\/jats:styled-content> to inactive metabolites. Functionally deficient alleles of <jats:italic><jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2B6<\/jats:italic> such as <jats:italic><jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2B6*6<\/jats:italic>,<jats:italic> *18<\/jats:italic>, and <jats:italic>*22<\/jats:italic> may be responsible for significantly higher therapeutic concentrations of <jats:styled-content style=\"fixed-case\">EFV<\/jats:styled-content> at a standard dose of 600 mg\/day. We conducted a thorough review of the reported studies to elucidate the relationship between polymorphisms in <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2B6 with adverse events and treatment response, including virologic suppression, immunologic response, resistance, and discontinuation of treatment. Compelling evidence exists to support the case for <jats:italic><jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>2B6<\/jats:italic> genotype\u2013guided <jats:styled-content style=\"fixed-case\">EFV<\/jats:styled-content> therapy while acknowledging the need for prospective controlled clinical trials to evaluate its clinical utility.<\/jats:p>","DOI":"10.1002\/phar.1852","type":"journal-article","created":{"date-parts":[[2016,10,25]],"date-time":"2016-10-25T11:17:05Z","timestamp":1477394225000},"page":"1245-1254","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Role of Cytochrome P450 2B6 Pharmacogenomics in Determining Efavirenz\u2010Mediated Central Nervous System Toxicity, Treatment Outcomes, and Dosage Adjustments in Patients with Human Immunodeficiency Virus Infection"],"prefix":"10.1002","volume":"36","author":[{"given":"Teresa 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