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are associated with altered warfarin pharmacokinetics. Two minor variants, CYP2C9 * 2 (rs1799853, C>T) and CYP2C9 * 3 (rs1057910, A>C), have been proven to reduce warfarin metabolism and thus reduce the dose requirement in patients taking regular warfarin. The frequencies of CYP2C9 polymorphisms differ with ethnicity. In Thailand, the frequency of CYP2C9 * 1 /* 3 (heterozygous AC of rs1057910) has been reported at 2.8%–8.6% [ 7 , 8 , 10 ], CYP2C9 * 3 /* 3 (homozygous CC of rs1057910) as a very rare genotype, and CYP2C9 * 2 has never been reported
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regimens [ 52 ]. Efavirenz causes central neurological side-effects and rash in 5%–10% of treated patients which limits the tolerability of the drug, and this may prove a challenge for Asia, while implementing recommendations to commence ART at a 500 cell/mm 3 CD4 count or higher threshold.
Optimizing antiretroviral therapy in Asia
In general, ARV drug development for licensing has been based on pharmacokinetic results among Western volunteers. Furthermore, the final dose selected for phase III trials and approval is decided by the principle of selecting the