{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:02:30Z","timestamp":1773162150226,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T00:00:00Z","timestamp":1603238400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["NS094037"],"award-info":[{"award-number":["NS094037"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Interactions between enzyme\u2010inducing anti\u2010seizure medications (EI\u2010ASMs) and antiretroviral drugs (ARVs) can lead to decreased ARV levels and may increase the likelihood of viral resistance. We conducted a study to determine if co\u2010usage of ARVs and EI\u2010ASMs is associated with ARV\u2010resistant human immunodeficiency virus (HIV) among people living with HIV in Zambia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eligible participants were \u226518\u00a0years of age and concurrently taking ASMs and ARVs for at least 1\u00a0month of the prior 6\u2010month period. Data were obtained regarding medication and HIV history. CD4 counts, plasma viral loads (pVLs), and HIV genotype and resistance profile in participants with a pVL &gt;1000\u00a0copies\/mL were obtained. Pearson's test of independence was used to determine whether treatment with EI\u2010ASM was associated with pVL &gt;1000\/mL copies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 50 participants, 41 (82%) were taking carbamazepine (37 on monotherapy), and all had stable regimens in the prior 6\u00a0months. Among the 13 ARV regimens used, 68% had a tenofovir\/lamivudine backbone. The majority (94%) were on a stable ARV regimen for &gt;6\u00a0months. Median CD4 nadir was 205 cells\/mm<jats:sup>3<\/jats:sup> (interquartile range [IQR] 88\u2010389), and 60% of participants had commenced ARV treatment before advanced disease occurred. Mean CD4 count at enrollment was 464\u00a0cells\/mm<jats:sup>3<\/jats:sup> (SD 226.3). Seven participants (14%) had a CD4 count &lt;200\u00a0cells\/mm<jats:sup>3<\/jats:sup>. Four (8%) had a pVL &gt;1000\u00a0copies\/mL; all were on carbamazepine. Three participants with elevated pVL had a CD4 count &lt;200\u00a0cells\/mm<jats:sup>3<\/jats:sup>. None had documented adherence concerns by providers; however, two had events concerning for clinical failure. HIV genotype testing showed mutations in three participants. Carbamazepine was not found to correlate with elevated pVL (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.58).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>EI\u2010ASMs are commonly used in sub\u2010Saharan Africa. Despite concurrent use of EI\u2010ASMs and ARVs, the majority of participants showed CD4 counts &gt;200 cells\/mm<jats:sup>3<\/jats:sup> and were virally suppressed. Carbamazepine was not associated with an increased risk of virological failure or ARV\u2010resistant HIV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.16723","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T09:20:44Z","timestamp":1603272044000},"page":"2705-2711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluating the impact of antiretroviral and antiseizure medication interactions on treatment effectiveness among outpatient clinic attendees with HIV in Zambia"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4353-3849","authenticated-orcid":false,"given":"Allison","family":"Navis","sequence":"first","affiliation":[{"name":"Department of Neurology Icahn School of Medicine at Mount Sinai New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ifunanya","family":"Dallah","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester Rochester NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Mabeta","sequence":"additional","affiliation":[{"name":"Chikankata Epilepsy Care Team Mazabuka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalo","family":"Musukuma","sequence":"additional","affiliation":[{"name":"University Teaching Hospitals Children's Hospital Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Omar K.","family":"Siddiqi","sequence":"additional","affiliation":[{"name":"Global Neurology Program Department of Neurology Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Department of Internal Medicine Center for Vaccines and Virology Research Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Department of Internal Medicine University of Zambia School of Medicine Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher M.","family":"Bositis","sequence":"additional","affiliation":[{"name":"Greater Lawrence Family Health Center Lawrence MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Igor J.","family":"Koralnik","sequence":"additional","affiliation":[{"name":"Department of Neurology Northwestern University Feinberg School of Medicine Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harris A.","family":"Gelbard","sequence":"additional","affiliation":[{"name":"Departments of Neurology Pediatrics, Neuroscience and Microbiology and Immunology University of Rochester Medical Center Rochester NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4669-5747","authenticated-orcid":false,"given":"William H.","family":"Theodore","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke Bethesda MD USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason F.","family":"Okulicz","sequence":"additional","affiliation":[{"name":"Infectious Disease Service Brooke Army Medical Center Joint Base San Antonio\u2010Ft Sam Houston Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics Center for AIDS Research University of Rochester Rochester NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izukanji","family":"Sikazwe","sequence":"additional","affiliation":[{"name":"Center for Infectious Disease Research in Zambia (CIDRZ) Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David R.","family":"Bearden","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester Rochester NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gretchen L","family":"Birbeck","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Rochester Rochester NY USA"},{"name":"Chikankata Epilepsy Care Team Mazabuka Zambia"},{"name":"University Teaching Hospitals Children's Hospital Lusaka Zambia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,10,21]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"WHO.Epilepsy.2019. 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Department of Health and Human Services. Available athttp:\/\/www.aidsinfo.nih.gov\/ContentFiles\/AdultandAdolescentGL.pdf. Accessed August 1 2020. page C\u201012."},{"key":"e_1_2_10_18_1","unstructured":"Clinton Health Access Initiative.ARV Market Report: The state of the antiretroviral drug market in low\u2010 and middle\u2010income countries 2016\u20132021. 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