All the above factors might be involved, although the prevailing factor is drug-drug interactions in drug addicts infected with HIV, namely the following drugs competing with each other at the active center of hepatic CYP3A4: methadone vs NNRTIs, PI vs NNRTIs, epistatins vs NNRTIs, antifungal ketoconazole vs NNRTIs, taxol vs NNRTIs, etc.

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