[New 2015]

Recommendation(s)

In comparison with enzyme-inducing antiseizure medicines (phenobarbital, phenytoin, carbamazepine) or valproic acid, newer generation anti-seizure medicines that are not hepatically metabolized (i.e. leviteracetam, lacosamide, topiramate, gabapentin and pregabalin) may be preferred to use in people with HIV on certain antiretroviral medications (protease inhibitors or non-nucleoside reverse-transcriptase inhibitors).

If the treatment with newer generation antiseizure medicines is not feasible, valproic acid is preferred over the enzyme-inducing antiseizure medicines (phenobarbital, phenytoin, and carbamazepine). In all cases, close monitoring of HIV viral load and regular clinical monitoring is required. If resources are available, antiseizure medicine levels should be monitored.
Strength of recommendation: CONDITIONAL
Quality of evidence: VERY LOW