Literature DB >> 24215356

Risk of clinically significant depression in HIV-infected patients: effect of antiretroviral drugs.

F Gutiérrez1, L García, S Padilla, D Alvarez, S Moreno, G Navarro, Jl Gómez-Sirvent, F Vidal, V Asensi, M Masiá.   

Abstract

OBJECTIVES: We aimed to characterize depression in newly diagnosed HIV-infected patients, to determine the effect of antiretroviral therapy (ART) on its incidence, and to investigate whether efavirenz use was associated with a higher risk, compared with non-efavirenz-containing regimens, in the Spanish CoRIS cohort.
METHODS: CoRIS is a contemporary, multicentre cohort of HIV-infected patients, antiretroviral-naïve at entry, launched in 2004. Poisson regression models were used to investigate demographic, clinical and treatment-related factors associated with a higher incidence of clinically significant depression to October 2010.
RESULTS: In total, 5185 patients (13 089 person-years) participated in the study, of whom 3379 (65.2%) started ART during follow-up. The incidence rates of depression before and after starting ART were 11.68 [95% confidence interval (CI) 9.01-15.15] and 7.06 (95% CI 5.45-9.13) cases per 1000 person-years, respectively. After adjustment, there was an inverse association between the occurrence of depression and the initiation of ART [incidence rate ratio (IRR) 0.53; 95% CI 0.28-0.99], while the likelihood of depression increased in patients of age > 50 years (IRR 1.94; 95% CI 1.21-3.12). Longer exposure to ART was associated with a decreased IRR of depression in unadjusted and adjusted analyses. The IRR for patients receiving < 2, 2-4 and > 4 years of ART was 0.72 (95% CI 0.36-1.44), 0.10 (95% CI 0.04-0.25) and 0.05 (95% CI 0.01-0.17), respectively, compared with ART-naïve patients. This protective effect was also observed when durations of exposure to nonnucleoside reverse transcriptase inhibitor-based regimens and efavirenz-containing regimens were analysed separately.
CONCLUSIONS: The incidence of clinically significant depression was lower among HIV-infected patients on ART. The protective effect of ART was also observed with efavirenz-containing regimens.
© 2013 British HIV Association.

Entities:  

Keywords:  antiretroviral therapy; comorbidity; efavirenz; neurologic complications; non-AIDS events; psychiatric events

Mesh:

Substances:

Year:  2013        PMID: 24215356     DOI: 10.1111/hiv.12104

Source DB:  PubMed          Journal:  HIV Med        ISSN: 1464-2662            Impact factor:   3.180


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