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Blood samples collected at mid\u2010dose interval were used to quantify the plasma concentrations of EFV (denoted [EFV]), its major metabolite 8\u2010OH\u2010EFV ([8\u2010OH\u2010EFV]) and [8\u2010OH\u2010EFV]\/[EFV] metabolic ratio, and to genotype single nucleotide polymorphisms in <jats:italic>CYP2B6<\/jats:italic> (rs3745274, c.516G\u2009&gt;\u2009T; rs28399499, c.983\u2009T\u2009&gt;\u2009C) and <jats:italic>ABCB1<\/jats:italic> (rs3842, c.4036G\u2009&gt;\u2009A). CYP2B6 metabolic phenotypes were inferred from the <jats:italic>CYP2B6<\/jats:italic> diplotypes. Linear regression modelling was applied to identify sociodemographic, clinical and pharmacogenetic predictors of [EFV] and [8\u2010OH\u2010EFV]\/[EFV] metabolic ratio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Wide (50\u2010fold) interindividual variation in [EFV], [8\u2010OH\u2010EFV] and [8\u2010OH\u2010EFV]\/[EFV] was observed; 69.5% of participants had [EFV] within the nominal therapeutic range (1000\u20134000\u2009ng\/mL), while 19.5 and 11.0% had [EFV] below and above this range, respectively. Multiple regression modelling retained only CYP2B6 metabolic phenotypes or the combined rs3745274 and rs28399499 genotypes, as significant predictors of [EFV] and [8\u2010OH\u2010EFV]\/[EFV].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>EFV exposure and disposition varied widely among HIV\u2010infected Brazilians under stable treatment with EFV\u2010containing ART regimens. About 1\/10 of the participants had [EFV] exceeding nominal supratherapeutic concentration (4000\u2009ng\/mL), but reported tolerance to the ARV regimens, while 1\/5 of participants had nominal subtherapeutic [EFV] (&lt;1000\u2009ng\/mL) but adequate virological response. Genotype for the 2 CYP2B6 single nucleotide polymorphisms studied explained 48% of variation in [EFV] and 35% of variation in [8\u2010OH\u2010EFV]\/[EFV].<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.15387","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T04:48:54Z","timestamp":1651812534000},"page":"4585-4594","source":"Crossref","is-referenced-by-count":5,"title":["Pharmacogenetic predictors of variability in efavirenz pharmacokinetics in an admixed Brazilian HIV cohort"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6414-5220","authenticated-orcid":false,"given":"Jo\u00e3o Paulo","family":"Ximenez","sequence":"first","affiliation":[{"name":"Faculdade de Ci\u00eancias Farmac\u00eauticas de Ribeir\u00e3o Preto Universidade de S\u00e3o Paulo  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0193-7738","authenticated-orcid":false,"given":"Anna Beatriz Ribeiro","family":"Elias","sequence":"additional","affiliation":[{"name":"Coordena\u00e7\u00e3o de Pesquisa Instituto Nacional de C\u00e2ncer  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7024-4252","authenticated-orcid":false,"given":"Glauco Henrique Balthazar","family":"Nardotto","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias Farmac\u00eauticas de Ribeir\u00e3o Preto Universidade de S\u00e3o Paulo  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6672-578X","authenticated-orcid":false,"given":"Paulo Feij\u00f3","family":"Barroso","sequence":"additional","affiliation":[{"name":"Hospital Universit\u00e1rio Clementino Fraga Filho, Faculdade de Medicina Universidade Federal do Rio de Janeiro  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-4701","authenticated-orcid":false,"given":"Valdes Roberto","family":"Bollela","sequence":"additional","affiliation":[{"name":"Faculdade de Medicina de Ribeir\u00e3o Preto Universidade de S\u00e3o Paulo  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0074-4953","authenticated-orcid":false,"given":"Vera Lucia","family":"Lanchote","sequence":"additional","affiliation":[{"name":"Faculdade de Ci\u00eancias Farmac\u00eauticas de Ribeir\u00e3o Preto Universidade de S\u00e3o Paulo  Ribeir\u00e3o Preto Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-8319","authenticated-orcid":false,"given":"Guilherme","family":"Suarez\u2010Kurtz","sequence":"additional","affiliation":[{"name":"Coordena\u00e7\u00e3o de Pesquisa Instituto Nacional de C\u00e2ncer  Rio de Janeiro Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,5,25]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"UNAIDS.Global HIV & AIDS Statistics\u20142020 Fact Sheet. 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