brainsci-09-00195-v2.pdf (766.2 kB)
Improved central nervous system symptoms in people with HIV without objective neuropsychiatric complaints switching from Efavirenz to Rilpivirine containing cART
journal contribution
posted on 2023-06-09, 18:46 authored by Jaime Vera RojasJaime Vera Rojas, Margherita Bracchi, Jasmini Alagaratnam, Julianne Lwanga, Julie Fox, Alan Winston, Marta Boffito, Mark NelsonObjective: Occult central nervous system (CNS) symptoms not recognized by people living with HIV (PLWH) receiving efavirenz or their clinicians could occur and impact people’s quality of life. The aim of this study was to determine whether CNS parameters improve in PLWH when switching from efavirenz to rilpivirine. Methods: PLWH receiving tenofovir disoproxil fumarate, emtricitabine, efavirenz (Atripla™) with undetectable HIV RNA, and no CNS symptoms were switched cART to tenofovir disoproxil fumarate, emtricitabine, rilpivirine (Eviplera™). CNS parameters including sleep, anxiety, and depressive symptoms were evaluated using patient-reported outcome measures at baseline, 4, 12, and 24 weeks after switching therapy. A median CNS score was derived from the sum of CNS toxicities of all the grades collected in the study questionnaires. Cognitive function was assessed using a computerized test battery. Results: Of 41 participants, median age was 47 years, Interquartile range (IQR) 31, 92% were male and 80% were of white ethnicity. A significant reduction in total CNS score (10 to 7) was observed at 4 weeks (p = 0.028), but not thereafter. Significant improvements in sleep and anxiety were observed 4, 12 and 24 weeks after switching therapy (p < 0.05). No significant change in global cognitive scores was observed. Conclusions: Switching from efavirenz to rilpivirine based regimens in virologically suppressed PLWH without perceived CNS symptoms was well tolerated and slightly improved overall CNS symptoms.
History
Publication status
- Published
File Version
- Published version
Journal
Brain SciencesISSN
2076-3425Publisher
MDPIExternal DOI
Issue
8Volume
9Article number
a195Department affiliated with
- Global Health and Infection Publications
Research groups affiliated with
- Brighton and Sussex Centre for Global Health Research Publications
Full text available
- Yes
Peer reviewed?
- Yes
Legacy Posted Date
2019-08-27First Open Access (FOA) Date
2019-08-27First Compliant Deposit (FCD) Date
2019-08-27Usage metrics
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