Reversibility of Neuropsychiatric Adverse Events after Switching to Darunavir/Cobicistat or Doravirine in Men on INSTI-Based Regimen
José Antonio Mata-Marín,
Carina Aurora Juárez-Contreras,
Mara Soraya Rodríguez-Evaristo,
Olivia Concepción Martínez-Carrizales,
Ericka Pompa-Mera,
Alberto Chaparro Sánchez,
Salma Triana-González,
Ana Luz Cano-Díaz,
Jesús Enrique Gaytán-Martínez
Affiliations
José Antonio Mata-Marín
Infectious Diseases Department, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Carina Aurora Juárez-Contreras
Infectious Diseases Department, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Mara Soraya Rodríguez-Evaristo
Internal Medicine Department, Hospital de Especialidades, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Olivia Concepción Martínez-Carrizales
Psychiatric Department, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Ericka Pompa-Mera
Research Unit, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Alberto Chaparro Sánchez
Infectious Diseases Department, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Salma Triana-González
Infectious Diseases Department, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Ana Luz Cano-Díaz
Infectious Diseases Department, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Jesús Enrique Gaytán-Martínez
Infectious Diseases Department, Hospital de Infectología, “La Raza” National Medical Center, Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
Integrase strand transfer inhibitors (INSTI) are associated with neuropsychiatric adverse events (NPAEs). The aim of this study was to evaluate improvements in NPAEs after switching an INSTI-based regimen to darunavir/cobicistat (DRV/c) or doravirine (DOR). Methods: A prospective cohort study was conducted to evaluate the reversibility of NPAEs via the Patient Health Questionnaire (PHQ-9), the Insomnia Severity Index (ISI), and the Hospital Anxiety and Depression Scale (HADS-A and D) in patients who started antiretroviral therapy with dolutegravir (DTG) or bictegravir (BIC). These patients were switched to DRV/c or DOR. Scales were compared at the moment of the switch and 12 weeks later. Results: We included 1153 treatment-naïve men, 676 (58.7%) with BIC and 477 (41.3%) with DTG. A total of 32 (2.7%) experienced NPAEs that led to discontinuation. Insomnia was found in 20 patients; depression via PHQ-9 in 21 patients, via HADS-D in 5 patients, and anxiety via HADS-A in 12 patients. All of them were evaluated by a psychiatrist at the moment of the symptoms; 7 (21.8%) started psychotropic drugs. After 12 weeks of follow-up, PHQ-9, ISI, HADS-A, and HADS-D decreased, with a p-value ≤ 0.05. Conclusions: NPAEs seem to improve after switching to a DRV/c- or DOR-based regimen after the first 4 and 12 weeks.