Anxiety, depression, and sleep disturbances among people on long-term efavirenz-based treatment for HIV: a cross-sectional study in Beijing, China

Abstract

Background 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). Methods 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. Results 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. Conclusions 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.

Neuropsychiatric Adverse Events Following Antiretroviral Therapy in People Living with HIV: A Real-World Study of Dynamic Trends and Risk Factors in Hangzhou, China

“…Our results are consistent with previous studies showing that symptoms of sleep disorders, anxiety, and depression are common among PLWH. 16 , 17 , 25 Consistent with a previous study, our analysis revealed a dynamic correlation among sleep disorders, anxiety, and depression symptoms over the 12-month treatment period. 4 Our data also demonstrate a greater correlation between sleep disorders and anxiety symptoms than between sleep disorders and depression symptoms in PLWH, and this is consistent with a previous study among healthy individuals.…”

Self-Reported Health-Related Quality of Life and Residual Symptoms among Virologically Suppressed People Living with HIV in the Era of Single-Tablet Regimens in Taiwan: A Cross-Sectional Study

“…Studies have shown that concerns about appearance-related side effects underlay psychological distress, depression, and ART non-adherence among PLWH [ 47 , 48 ]. Sleep-related issues, such as insomnia or hypersomnia, usually associated with extreme fatigue, were also common among virologically suppressed PLWH or long-term ART [ 49 , 50 , 51 ]. HIV-related sleep disturbances have been linked to psychological disturbances and pain [ 52 , 53 ].…”

“…HIV-related sleep disturbances have been linked to psychological disturbances and pain [ 52 , 53 ]. Considering that some HIV-related symptoms (appearance change and sleep disturbances) could be attributed to ART [ 48 , 49 , 50 , 54 ], it may be of interest to further understand if potential side effects of ARTs could contribute to the symptom burden of HIV and intervene as appropriate [ 55 ]. Collectively, these suggest a need to assess factors contributing to and reducing residual symptom burden in PLWH with sustained viral suppression.…”

Prevalence of depression among people living with HIV in rural hospitals in South-Western Nigeria-Association with clinico-demographic factors

“…However, few participants were on efavirenz-containing ART, as the favoured first-line ART in Nigeria is dolutegravir-containing ART. Efavirenz has psychotropic properties, and chronic use has been associated with depression [ 34 , 35 ]. Also, studies have reported improving depression after discontinuing long-term efavirenz treatment [ 36 ].…”