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. 2020 Apr 10;222(5):777–786. doi: 10.1093/infdis/jiaa169

Figure 4.

Figure 4.

Comparison of NVP and EFV levels in plasma and CVL of females with vs without DS during ART. NVP (circles) and EFV (squares) levels measured in plasma (A and B) and CVL (C and D) by tandem mass spectrometry are shown relative to lower limit of therapeutic levels for NVP 3000 ng/mL and EFV 1000 ng/mL in the plasma (dashed lines). Median NVP plasma levels did not differ significantly between time points when DS was vs was not detected, nor did levels differ from matched participants without DS detected. Fewer participants took EFV, yielding too few values for a meaningful comparison. Therapeutic EFV plasma levels in female participant 86 with multiple HIV RNA templates amplified from genital tract DS specimen are indicated by inverted triangles. CVL NVP and EFV levels were all below the therapeutic levels of these antiretrovirals due to dilution of cervicovaginal secretions with 10 mL saline. Abbreviations: ART, antiretroviral treatment; CVL, cervicovaginal lavage; DS, discordant shedding; EFV, efavirenz; NS, not significant; NVP, nevirapine.