Your browser doesn't support javascript.
loading
Switching from efavirenz to elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide reduces central nervous system symptoms in people living with HIV / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 2850-2856, 2021.
Article in English | WPRIM | ID: wpr-921172
ABSTRACT
BACKGROUND@#Central nervous system (CNS) symptoms after efavirenz (EFV) treatment in people living with human immunodeficiency virus (HIV) could persist and impact their quality of life. We assessed the impact of EFV-based regimen replacement with elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide (E/C/F/TAF), which is considered an alternative option for subjects who do not tolerate EFV. Most specifically, we assessed the safety and the efficacy of E/C/F/TAF and its effects on the participants' neuropsychiatric toxicity symptoms in a real-life setting.@*METHODS@#A prospective cohort study was conducted among virologic suppressed HIV-positive participants receiving EFV-based regimens with ongoing CNS toxicity ≥ grade 2. The participants were switched to single-pill combination regimens E/C/F/TAF and followed up for 48 weeks. The neuropsychiatric toxicity symptoms were measured using a CNS side effects questionnaire, as well as the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index. The primary outcome measure was the proportion of participants experiencing grade 2 or higher CNS toxicity after EFV switch off at weeks 12, 24, and 48. Secondary endpoints included virologic and immunological responses and the effect on fasting lipids at week 48 after switch.@*RESULTS@#One hundred ninety-six participants (96.9% men, median age 37.5 years, median 3.7 years on prior EFV-containing regimens) were included in the study. Significant improvements in anxiety and sleep disturbance symptoms were observed at 12, 24, and 48 weeks after switching to E/C/F/TAF (P < 0.05). No significant change in depression symptom scores was observed. At 48 weeks after switch, HIV viral load <50 copies/mL was maintained in all of the participants, median fasting lipid levels were moderately increased (total cholesterol [TC] 8.2 mg/dL, low-density lipoprotein cholesterol [LDL-C] 8.5 mg/dL, high-density lipoprotein cholesterol [HDL-C] 2.9 mg/dL, and triglyceride (TG) 1.6 mg/dL, and the TCHDL-C ratio remained stable.@*CONCLUSIONS@#The single-pill combination regimens E/C/F/TAF is safe and well tolerated. This study reveals that switching from EFV to E/C/F/TAF significantly reduces neuropsychiatric toxicity symptoms in people living with HIV with grade 2 or higher CNS complaints.
Subject(s)
Full text: Available Index: WPRIM (Western Pacific) Main subject: Quality of Life / Adenine / HIV Infections / Central Nervous System / Prospective Studies / Quinolones / Anti-HIV Agents / Cyclopropanes / Benzoxazines / Alanine Type of study: Diagnostic study / Observational study / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2021 Type: Article

Similar

MEDLINE

...
LILACS

LIS

Full text: Available Index: WPRIM (Western Pacific) Main subject: Quality of Life / Adenine / HIV Infections / Central Nervous System / Prospective Studies / Quinolones / Anti-HIV Agents / Cyclopropanes / Benzoxazines / Alanine Type of study: Diagnostic study / Observational study / Risk factors Limits: Adult / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2021 Type: Article