Long term administration of nevirapine causes functional derangement of various tissues. This study was therefore carried out to determine the effect of long term administration of nevirapine on intestinal fluid and glucose absorption in albino Wistar rats using the everted sac technique. Twenty albino Wistar rats (both sexes) were divided into two groups of ten rats per group. The first group served as the control and was fed with normal rat chow while the second group was fed nevirapine (0.4 mg/kg body weight) by gavage once daily for 2 weeks after which the dosage was doubled by administering the drug twice daily for 12 weeks. Villus height and crypt depth were measured. The gut fluid uptake (jejunum/ileum) in nevirapine-treated rats were significantly lower (p<0.001) when compared to control; gut glucose uptake (jejunum/ileum) were significantly lower (p<0.001and p<0.05) in the nevirapine-treated group of rats when compared to control. The villus height (duodenum, jejunum, ileum) in the nevirapine-treated group was significantly lower (p<0.01, p<0.01, p<0.001) as compared to control group. The crypt depth (duodenum, jejunum, ileum) in the nevirapine-treated group was significantly lower (p<0.001, p<0.01, p<0.01) when compared to control. These results suggest that long term administration of nevirapine may lead to distortion in villus morphology with a concomitant mal-absorption of fluid and glucose in rats.

HIV-1/AIDS patients are currently being treated with a single drug or different combinations of 22 ARV agents approved by the FDA for clinical use. These drugs have been developed to target viral enzymes such as HIV-1RT, protease, and integrase encoded by the pol gene of the virus. Several small molecules have also been developed against different stages of the viral life cycle. Some of them have entered into various stages of basic and clinical development. Most of these drugs have been found to induce moderate to severe toxic effects after long term use and therefore pose a challenge to chemotherapy. Because of the side effects, adherence to treatment has always been at stake, and discontinuation of treatment in many cases further aggravates the drug resistance problem. Therefore, knowledge about the mechanisms of action of these drugs, their interactions with other concomitantly administered drugs, development of newer and safer ARVs, and effective management practices to combat drug-induced toxicity are urgently required for successful treatment of the disease.