Clinical data on the relationships of cytochrome P450 (CYP2) B6 516G>T polymorphisms with efavirenz-induced central nervous system (CNS) side effects and virological response in HIV-infected adults are controversial. We sought to analyze the associations by meta-analysis. To identify eligible studies, we systematically searched PubMed, Embase, ScienceDirect, and Web of Science. The strength of the associations was measured by odds ratio (OR) and effect size (ES) with 95% confidence interval (CI). Seventeen studies comprising a total of 3598 HIV-infected adults were included. The results showed that the CYP2B6-516 GG genotype was significantly associated with a decreased risk of efavirenz-induced CNS side effects compared with the GT and TT genotypes (GG + GT vs. TT: OR = 0.60, 95% CI = 0.41–0.87, P = 0.006; GG vs. GT + TT: OR = 0.68, 95% CI = 0.51–0.91, P = 0.008; GG vs. GT: OR = 0.70, 95% CI = 0.51–0.94, P = 0.018), and there was no significant association between the genetic variants GT and TT (GT vs. TT: OR = 0.82, 95% CI = 0.54–1.26, P = 0.372). However, there was no significant association between CYP2B6-516 GG and GT + TT genotypes in virological response (GT + TT vs. GG: ES = 1.06, 95% CI = 0.95–1.18, P = 0.321; OR = 1.01, 95% CI = 0.65–1.58, P = 0.963). Taken together, our results demonstrated that compared with the normal efavirenz clearance genotype CYP2B6-516 GG, the slow and very slow efavirenz clearance genotypes GT and TT were significantly associated with an increased risk of efavirenz-induced CNS side effects but not an increased virological response. To promote the tolerance of efavirenz, it is better to adjust the dosage of efavirenz according to the polymorphisms of CYP2B6-516 in HIV-infected adults.

在HIV感染的成年人中，细胞色素P450（CYP2）B6 516G> T多态性与依非韦伦诱导的中枢神经系统（CNS）副作用和病毒学应答之间的关系的临床数据引起争议。我们试图通过荟萃分析来分析关联。为了确定合格的研究，我们系统地搜索了PubMed，Embase，ScienceDirect和Web of Science。关联的强度通过比值比（OR）和效应大小（ES）以及95％的置信区间（CI）进行衡量。包括总共3598名HIV感染的成年人在内的17项研究被纳入。结果表明，与GT和TT基因型相比，CYP2B6-516 GG基因型与依法韦仑诱导的CNS副作用风险降低显着相关（GG + GT vs. TT：OR = 0.60，95％CI = 0.41-0.87 ，P  = 0.006； GG vs. GT + TT：OR = 0.68，95％CI = 0.51-0.91，P  = 0.008； GG vs. GT：OR = 0.70，95％CI = 0.51-0.94，P  = 0.018），而且遗传变异GT和TT之间没有显着关联（GT与TT：OR = 0.82，95％CI = 0.54–1.26，P = 0.372）。但是，CYP2B6-516 GG与GT + TT基因型之间在病毒学应答方面无显着相关性（GT + TT与GG：ES = 1.06，95％CI = 0.95-1.18，P  = 0.321； OR = 1.01，95％ CI = 0.65-1.58，P  = 0.963）。两者合计，我们的结果表明，与正常依法韦仑清除基因型CYP2B6-516 GG相比，慢和非常慢的依法韦仑清除基因型GT和TT与依法韦仑诱导的中枢神经系统副作用的风险增加显着相关，但病毒学应答并未增加。为了提高依非韦伦的耐受性，最好根据被艾滋病毒感染的成年人中CYP2B6-516的多态性来调整依非韦伦的剂量。