Yijia Li1, Zheng Wang2, Yu Cheng2,3, James T Becker3, Eileen Martin4, Andrew Levine5, Leah H Rubin6, Ned Sacktor6, Ann Ragin7, Ken Ho1,8. 1. University of Pittsburgh School of Medicine. 2. Department of Statistics. 3. Department of Psychiatry, University of Pittsburgh, Pittsburgh. 4. Rush University School of Medicine, Chicago. 5. Department of Neurology, UCLA - David Geffen School of Medicine, Los Angeles. 6. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore. 7. Feinberg School of Medicine, Northwestern University, Chicago. 8. Division of Infectious Diseases, Department of Medicine, University of Pittsburgh, Pittsburgh, USA.
Abstract
BACKGROUND: Efavirenz is associated with side effects involving the central nervous system. However, it remains largely unknown whether switching off EFV improves neuropsychological performance. METHODS: We utilized data from the Multicenter AIDS Cohort Study (MACS). Participants were categorized by their use of EFV: never on EFV (No EFV), continuously on EFV (No Switch-OFF) and on EFV and then switched off (Switch-OFF). Baseline time points were defined as visits when first neuropsychological data were available. In Analysis 1, we compared neuropsychological and Center for Epidemiological Studies-Depression Scale (CES-D) scores before and after EFV switch in Switch-OFF group, aligning participants at the time of switch. Analysis 2 evaluated trajectory of neuropsychological/CES-D score among the three groups. RESULTS: This analysis included 1989 HIV-seropositive participants with neuropsychological data (1675 in No EFV, 44 in No Switch-OFF, and 270 in Switch-OFF group). At baseline, participants had a median age of 37 years, median CD4 cell count 442 cells/μl, and 22.9% viral suppression rate. In Analysis 1, neuropsychological and CES-D scores did not show clinically significant changes over 2 years prior to and 4 years after switch in Switch-OFF group. In Analysis 2, trends in neuropsychological and CES-D scores in the three different groups did not show significant differences during a median of 3.2 years of follow-up. CONCLUSION: Discontinuation of EFV is not associated with changes in neuropsychological performance or severity of depression in men. Furthermore, we did not observe differences among participants who were never on EFV, continuously on EFV, and on EFV and then switched off.
BACKGROUND:Efavirenz is associated with side effects involving the central nervous system. However, it remains largely unknown whether switching off EFV improves neuropsychological performance. METHODS: We utilized data from the Multicenter AIDS Cohort Study (MACS). Participants were categorized by their use of EFV: never on EFV (No EFV), continuously on EFV (No Switch-OFF) and on EFV and then switched off (Switch-OFF). Baseline time points were defined as visits when first neuropsychological data were available. In Analysis 1, we compared neuropsychological and Center for Epidemiological Studies-Depression Scale (CES-D) scores before and after EFV switch in Switch-OFF group, aligning participants at the time of switch. Analysis 2 evaluated trajectory of neuropsychological/CES-D score among the three groups. RESULTS: This analysis included 1989 HIV-seropositive participants with neuropsychological data (1675 in No EFV, 44 in No Switch-OFF, and 270 in Switch-OFF group). At baseline, participantshad a median age of 37 years, median CD4 cell count 442 cells/μl, and 22.9% viral suppression rate. In Analysis 1, neuropsychological and CES-D scores did not show clinically significant changes over 2 years prior to and 4 years after switch in Switch-OFF group. In Analysis 2, trends in neuropsychological and CES-D scores in the three different groups did not show significant differences during a median of 3.2 years of follow-up. CONCLUSION: Discontinuation of EFV is not associated with changes in neuropsychological performance or severity of depression in men. Furthermore, we did not observe differences among participants who were never on EFV, continuously on EFV, and on EFV and then switched off.
Authors: Andrew Scourfield; Jiexin Zheng; Suchitra Chinthapalli; Laura Waters; Thomas Martin; Sundhiya Mandalia; Mark Nelson Journal: AIDS Date: 2012-07-17 Impact factor: 4.177
Authors: Jonathan L Chang; Alexander C Tsai; Nicholas Musinguzi; Jessica E Haberer; Yap Boum; Conrad Muzoora; Mwebesa Bwana; Jeffrey N Martin; Peter W Hunt; David R Bangsberg; Mark J Siedner Journal: Ann Intern Med Date: 2018-06-26 Impact factor: 25.391
Authors: N Ciccarelli; M Fabbiani; S Di Giambenedetto; I Fanti; E Baldonero; L Bracciale; E Tamburrini; R Cauda; A De Luca; M C Silveri Journal: Neurology Date: 2011-04-19 Impact factor: 9.910
Authors: Khutso M Mothapo; Arnt Schellekens; Reinout van Crevel; Monique Keuter; K Grintjes-Huisman; Peter Koopmans; Andre van der Ven Journal: CNS Neurol Disord Drug Targets Date: 2015 Impact factor: 4.388
Authors: B Payne; T J Chadwick; A Blamire; K N Anderson; J Parikh; J Qian; A M Hynes; J Wilkinson; D A Price Journal: HIV Med Date: 2017-03-01 Impact factor: 3.180
Authors: Juan Tiraboschi; Lisa Hamzah; Alastair Teague; Ranjababu Kulasegaram; Frank Post; Isabelle Jendruleck; Tammy Murray; Julie Fox Journal: AIDS Res Hum Retroviruses Date: 2016-08-22 Impact factor: 2.205
Authors: Asante R Kamkwalala; Kunbo Wang; Yanxun Xu; Leah H Rubin; Jane O'Halloran; Dionna W Williams; Raha Dastgheyb; Kathryn C Fitzgerald; Amanda B Spence; Pauline M Maki; Deborah R Gustafson; Joel Milam; Anjali Sharma; Kathleen M Weber; Adaora A Adimora; Igho Ofotokun; Anandi N Sheth; Cecile D Lahiri; Margaret A Fischl; Deborah Konkle-Parker Journal: AIDS Behav Date: 2021-01
Authors: Leah H Rubin; Yuliang Li; Yanxun Xu; Dionna W Williams; Kathryn C Fitzgerald; Raha Dastgheyb; Amanda B Spence; Pauline M Maki; Anjali Sharma; Deborah R Gustafson; Joel Milam; Kathleen M Weber; Adaora A Adimora; Norman J Haughey; Igho Ofotokun; Margaret A Fischl; Deborah Konkle-Parker Journal: J Neuroimmune Pharmacol Date: 2020-03-24 Impact factor: 7.285