Infection and Drug Resistance (Aug 2023)
Neuropsychiatric Adverse Events Following Antiretroviral Therapy in People Living with HIV: A Real-World Study of Dynamic Trends and Risk Factors in Hangzhou, China
Abstract
Wenhui Zhang,1,2,* Yi Wang,2,3,* Er Li,1 Dingyan Yan,1,2 Jianhua Yu,2 Mingli Zhu,4 Jinchuan Shi,2,* Liping Zheng1,* 1Department of Nursing, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 2Department of Infection, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 3Institute of Hepatology and Epidemiology, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China; 4Medical Laboratory, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, Hangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jinchuan Shi, Department of Infection, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, No. 2 Hengbu Street, Liuxia Town, Xihu District, Hangzhou, Zhejiang, People’s Republic of China, Email [email protected] Liping Zheng, Department of Nursing, Affiliated Hangzhou Xixi Hospital, Zhejiang University School of Medicine, No. 2 Hengbu Street, Liuxia Town, Xihu District, Hangzhou, Zhejiang, People’s Republic of China, Email [email protected]: Neuropsychiatric adverse events (NPAEs) occur frequently in people living with human immunodeficiency virus (PLWH) receiving antiretroviral therapy (ART). This study aimed to assess the dynamic trends and risk factors of NPAEs among PLWH in Hangzhou taking efavirenz (EFV)- or dolutegravir (DTG)- or elvitegravir (EVG)-based regimens.Patients and Methods: A total of 287 ART-naive PLWH were included in this study, EFV (400mg)- (n = 122), EFV (600mg)- (n = 37), DTG- (n = 73), EVG-based (n = 47) and other ART regimens (n = 8) as the initial ART regimen were administered for 12 months. All data were collected at five time points within a 12-month follow-up. The Pittsburgh Sleep Quality Index and Hospital Anxiety and Depression Scale were used to evaluate sleep disorders and anxiety and depression symptoms, respectively. The dynamic trends and potential risk factors of NPAEs were investigated using a generalized linear mixed model.Results: Mean age was 29.4 (SD: 7.5) years with 97.2% males. After 12 months of ART, the prevalence of sleep disorders and anxiety decreased significantly, although only a slight improvement was observed for depression. In addition, there was a significant positive correlation between sleep disorders, anxiety, and depression. The risk factors for NPAEs differed slightly depending on the choice of ART regimen, but the seven factors most commonly associated with NPAEs were age, sex, marital status, education level, smoking status, body mass index, and WHO clinical stage. Treatment-induced changes in CD4-positive T-cell count and virological suppression did not depend on the particular choice of ART regimen.Conclusion: The prevalence of sleep disorders and anxiety changed significantly over time on ART and the risks of these disorders were associated with seven common clinical and demographic factors.Keywords: sleep disorders, anxiety, depression, antiretroviral therapy, people living with HIV
