Li Chia-Wen, Chen Yen-Chin, Lee Nan-Yao, Chen Po-Lin, Li Ming-Chi, Li Chung-Yi, Ko Wen-Chien, Ko Nai-Ying
Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
Center for Infection Control, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
Healthcare (Basel). 2021 Nov 24;9(12):1625. doi: 10.3390/healthcare9121625.
(1) Background: This study aimed to determine the association between the use of efavirenz and depressive disorders among human immunodeficiency virus (HIV)-infected patients. (2) Methods: A retrospective cohort study was conducted using Taiwan's National Health Insurance Database. We identified patients receiving anti-retroviral therapy (ART) between 2000 and 2009; these patients were followed until 2010 for diagnoses of depressive disorders using the Cox proportional hazard model to estimate hazard ratios. (3) Results: After up to 11 years of follow-up, the incidence of depressive disorders for the efavirenz-treated group was estimated at 12.2/1000 person-years (PYs), and the control group was at 12.5/1000 PY ( = 0.822). The independent risk factors for depressive disorders included an insurance premium of less than NTD 17,820 (New Taiwan Dollars-NTD) (adjusted hazard ratio (aHR) 2.59, 95% confidence interval (CI), 1.79-3.76, < 0.001), and between NTD 17,821 and NTD 26,400 (aHR 1.55, 95% CI, 1.04-2.31, = 0.030), living in Southern Taiwan (aHR 1.49, 95% CI, 1.21-1.84, = 0.002), and with a psychiatric history (excluding depressive disorders) (aHR 4.59, 95% CI, 3.51-6.01, = 0.030). (4) Conclusions: This study concluded that ART-treated patients with a past history of psychiatric disorders, lower insurance premium, and living in Southern Taiwan have an increased risk of depressive disorders, which are not associated with the use of efavirenz.
（1）背景：本研究旨在确定感染人类免疫缺陷病毒（HIV）的患者使用依非韦伦与抑郁症之间的关联。（2）方法：利用台湾国民健康保险数据库进行了一项回顾性队列研究。我们确定了2000年至2009年期间接受抗逆转录病毒治疗（ART）的患者；使用Cox比例风险模型对这些患者进行随访直至2010年，以诊断抑郁症并估计风险比。（3）结果：经过长达11年的随访，依非韦伦治疗组抑郁症的发病率估计为12.2/1000人年（PYs），对照组为12.5/1000 PY（P = 0.822）。抑郁症的独立危险因素包括保险费低于新台币17,820元（新台币-NTD）（调整后风险比（aHR）2.59，95%置信区间（CI），1.79-3.76，P < 0.001），以及在新台币17,821元至26,400元之间（aHR 1.55，95% CI，1.04-2.31，P = 0.030），居住在台湾南部（aHR 1.49，95% CI，1.21-1.84，P = 0.002），以及有精神病史（不包括抑郁症）（aHR 4.59，95% CI，3.51-6.01，P = 0.030）。（4）结论：本研究得出结论，有精神病史、保险费较低且居住在台湾南部的接受抗逆转录病毒治疗的患者患抑郁症的风险增加，这与使用依非韦伦无关。
