Clinical Relevance of the 516 G>T Polymorphism in CYP2B6 and Its Effects on Efavirenz Concentrations in Patients with HIV and Tuberculosis: A Meta-analysis

The *CYP2B6* c.516 G>T polymorphism (TT genotype) reduces efavirenz metabolism and increases its plasma concentrations, exposing to neuropsychiatric and hepatic toxicities

This meta-analysis of 5 studies (373 patients) assesses the effect of the CYP2B6 c.516 G>T polymorphism on efavirenz plasma concentrations in HIV and tuberculosis patients. TT genotype carriers show significantly higher concentrations than GG and GT genotypes (mean differences of 5.65 and 6.41 µg/mL, p < 0.05). No difference is observed between GG and GT. The authors support the potential utility of CYP2B6 genotyping to optimize efavirenz dosing, particularly in TT carriers.

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The CYP2B6 516 G>T–efavirenz concentration association has long been well established; this meta-analysis confirms it without major novelty. Its added value lies in the HIV/tuberculosis context and quantitative consolidation, but ethnic heterogeneity and small sample size limit its scope. The link with clinical toxicity is not directly assessed, restricting immediate actionability.