Marion Sumari-de Boer1,2, Arnt Schellekens3,4, Ashanti Duinmaijer5, Julieth M Lalashowi6, Happiness J Swai6, Quirijn de Mast2,7, Andre van der Ven2,7, Grace Kinabo6,8. 1. Kilimanjaro Clinical Research Institute, Moshi, Tanzania. 2. Department of Internal Medicine, Radboudumc Nijmegen, Nijmegen, The Netherlands. 3. Donders Centre for Neuroscience, Department of Psychiatry, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands. 4. Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands. 5. Haydom Lutheran Hospital, Haydom, Tanzania. 6. Kilimanjaro Christian Medical University College, Moshi, Tanzania. 7. Radboud Centre for Infectious Diseases, Nijmegen, The Netherlands. 8. Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Abstract
OBJECTIVES: To explore the relationship between Efavirenz (EFV) and neuropsychiatric symptoms among adults and adolescents living with human immunodeficiency virus (HIV) in Kilimanjaro, Tanzania. METHODS: Cross-sectional study among HIV-infected adults (age 18-65) and adolescents (age 12-17) on antiretroviral treatment attending Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Neuropsychiatric symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), the Symptom Checklist 90 (SCL-90) and the Mini-International Neuropsychiatric Interview (MINI). manova and chi-squared tests were used to test differences between EFV and non-EFV-treated participants. RESULTS: A total of 215 adults and 150 adolescents participated. About 52% of adults and 37% of adolescents used EFV. Among adults, depression scores were higher for those on EFV (HADS (Cohen's D: 0.38; P = 0.02) and SCL-90 (Cohen's D: 0.24; P = 0.03). Among adolescents, those on EFV had lower scores on depression (HADS (Cohen's D: 0.3; P = 0.02) and SCL-90 (Cohen's D: 0.1; P = 0.02). About 10% of adults reported suicidal thoughts, but there was no difference between those on EFV and those without. Lastly, adults on EFV reported higher levels of problematic alcohol use (P = 0.003). CONCLUSIONS: In line with the previous studies, EFV is associated with depressive symptoms and problematic alcohol use among HIV-infected adults in Tanzania. In contrast, EFV was associated with lower levels of depressive symptoms in adolescents in Tanzania. Particularly among adults, close monitoring of depressive symptoms and alcohol use is indicated.
OBJECTIVES: To explore the relationship between Efavirenz (EFV) and neuropsychiatric symptoms among adults and adolescents living with human immunodeficiency virus (HIV) in Kilimanjaro, Tanzania. METHODS: Cross-sectional study among HIV-infected adults (age 18-65) and adolescents (age 12-17) on antiretroviral treatment attending Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Neuropsychiatric symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), the Symptom Checklist 90 (SCL-90) and the Mini-International Neuropsychiatric Interview (MINI). manova and chi-squared tests were used to test differences between EFV and non-EFV-treated participants. RESULTS: A total of 215 adults and 150 adolescents participated. About 52% of adults and 37% of adolescents used EFV. Among adults, depression scores were higher for those on EFV (HADS (Cohen's D: 0.38; P = 0.02) and SCL-90 (Cohen's D: 0.24; P = 0.03). Among adolescents, those on EFV had lower scores on depression (HADS (Cohen's D: 0.3; P = 0.02) and SCL-90 (Cohen's D: 0.1; P = 0.02). About 10% of adults reported suicidal thoughts, but there was no difference between those on EFV and those without. Lastly, adults on EFV reported higher levels of problematic alcohol use (P = 0.003). CONCLUSIONS: In line with the previous studies, EFV is associated with depressive symptoms and problematic alcohol use among HIV-infected adults in Tanzania. In contrast, EFV was associated with lower levels of depressive symptoms in adolescents in Tanzania. Particularly among adults, close monitoring of depressive symptoms and alcohol use is indicated.
Authors: Noeline Nakasujja; Alyssa C Vecchio; Deanna Saylor; Sarah Lofgren; Gertrude Nakigozi; David R Boulware; Alice Kisakye; James Batte; Richard Mayanja; Aggrey Anok; Steven J Reynolds; Thomas C Quinn; Carlos A Pardo; Anupama Kumar; Ronald H Gray; Maria J Wawer; Ned Sacktor; Leah H Rubin Journal: J Neurovirol Date: 2021-07-31 Impact factor: 3.739