University of Sussex
Browse
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

Download (766.2 kB)
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 Nelson
Objective: 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 Sciences

ISSN

2076-3425

Publisher

MDPI

Issue

8

Volume

9

Article number

a195

Department 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

2019-08-27

First Open Access (FOA) Date

2019-08-27

First Compliant Deposit (FCD) Date

2019-08-27

Usage metrics

    University of Sussex (Publications)

    Categories

    No categories selected

    Licence

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC