Peking University Ditan Teaching Hospital, Beijing, 100015, China.
National Center for Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, China.
BMC Psychiatry. 2022 Nov 16;22(1):710. doi: 10.1186/s12888-022-04366-4.
Efavirenz (EFV)-induced neuropsychiatric toxicity bothers people living with HIV (PLHIV). Neuropsychiatric adverse effects of EFV may differ by length of time on EFV-based antiretroviral treatment (ART).
A cross-sectional, single-center study was conducted at Beijing Ditan Hospital in China from June-August 2020 among ART-experienced PLHIV who were on long-term EFV-based ART. 424 eligible virological suppressed participants were enrolled and divided into four groups according to time on EFV-based ART: group A (0.5 ≤ ART < 2 year), B (2 ≤ ART < 4 year), C (4 ≤ ART < 6 year), and D (ART ≥ 6 year). The questionnaires about 12-item Short Form Health Survey (SF-12), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were administered to assess neuropsychiatric adverse events of EFV among different groups.
Overall mental component summary scores (MCS) of SF-12 in PLHIV was 50.2, which was lower than general population. Overall prevalence of anxiety, depression and sleep disturbances was 15.6%, 15.3% and 58%, respectively. Prevalence of anxiety, depression and sleep disturbances did not vary significantly between the time-on-ART groups. Anxiety, depression, sleep disturbances had no correlation with time on EFV-based ART or CD4 T cells counts.
In ART-experienced PLHIV in China, neuropsychiatric adverse events exist persistently and prevalence do not significantly change with prolonged time on EFV-based ART. The prevalence of sleep disturbances was high, suggesting that clinicians should pay more attention to long-standing psychiatric health to perform early and effective interventions.
依非韦伦（EFV）引起的神经精神毒性困扰着艾滋病毒感染者（PLHIV）。EFV 的神经精神不良反应可能因基于 EFV 的抗逆转录病毒治疗（ART）的时间长短而有所不同。
本研究于 2020 年 6 月至 8 月在北京地坛医院开展了一项横断面、单中心研究，纳入了正在接受长期 EFV 为基础的 ART 的 ART 经验丰富的 PLHIV。共有 424 名符合条件的病毒学抑制的参与者被纳入，并根据基于 EFV 的 ART 的时间分为四组：A 组（0.5<ART<2 年）、B 组（2<ART<4 年）、C 组（4<ART<6 年）和 D 组（ART≥6 年）。通过问卷调查了参与者的 12 项简短健康调查（SF-12）、医院焦虑和抑郁量表（HADS）和匹兹堡睡眠质量指数（PSQI），以评估不同组中 EFV 的神经精神不良反应。
PLHIV 的 SF-12 整体心理成分综合评分（MCS）为 50.2，低于一般人群。焦虑、抑郁和睡眠障碍的总患病率分别为 15.6%、15.3%和 58%。在不同 ART 组之间，焦虑、抑郁和睡眠障碍的患病率没有显著差异。焦虑、抑郁、睡眠障碍与基于 EFV 的 ART 时间或 CD4 T 细胞计数无相关性。
在中国接受 ART 治疗的 PLHIV 中，神经精神不良反应持续存在，且随着基于 EFV 的 ART 时间的延长，其患病率无显著变化。睡眠障碍的患病率较高，这表明临床医生应更加关注长期的精神健康，以便进行早期和有效的干预。
