Neuropsychiatric adverse drug reactions and associated factors in a cohort of individuals starting dolutegravir-based or efavirenz-based antiretroviral therapy in Belo Horizonte, Brazil.

Mendes, Jullye Campos; Braga, Maria das Graças; Reis, Adriano Max Moreira; Silveira, Micheline Rosa

Mendes, Jullye Campos; Braga, Maria das Graças; Reis, Adriano Max Moreira; Silveira, Micheline Rosa.

Afiliação

Mendes JC; Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Braga MDG; Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Reis AMM; Departamento de Farmácia Social, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Silveira MR; Programa de Pós Graduação em Medicamentos e Assistência Farmacêutica, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.

Curr Med Res Opin ; 39(4): 523-531, 2023 04.

Article em En | MEDLINE | ID: mdl-36912019

RESUMO

OBJECTIVE: To measure the incidence of neuropsychiatric adverse drug reactions (ADRs) in individuals living with HIV who initiated antiretroviral therapy (ART) with first-line regimens containing dolutegravir (DTG) or efavirenz (EFV) and associated factors. METHODS: Prospective cohort study with individuals living with HIV who started ART with DTG or EFV associated with tenofovir disoproxil and lamivudine in Belo Horizonte, Brazil. Sociodemographic, clinical, and laboratory data were collected from September 2015 to October 2018 in three specialized HIV care services through interviews, clinical records, and computerized systems. We analysed the frequency of neuropsychiatric ADRs recorded in clinical records 12 months after starting antiretroviral use, and the associated factors were investigated using binary logistic regression. RESULTS: A total of 152 (35.1%) of the 433 individuals included had neuropsychiatric ADRs. The incidence density was 35.3/100 person-years. The subjects mainly had sleep disorders and disturbances (21.3%), neurological disorders (13.9%), headaches (8.1%), and anxiety disorders and symptoms (3.0%), more frequently in individuals using EFV. A lower likelihood of neuropsychiatric ADRs was associated with using a DTG-based antiretroviral regimen (OR = 0.24; 95% CI = 0.14-0.40) and anxiety or depression signs and symptoms at the onset of treatment (OR = 0.57; 95% CI = 0.37-0.89). CONCLUSION: The incidence of neuropsychiatric ADRs was high in individuals starting ART with a lower likelihood of using a DTG-based regimen. The DTG-based regimen had a better safety profile for neuropsychiatric ADRs than the EFV-based regimen.

Assuntos

Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos; Infecções por HIV; Humanos; Estudos Prospectivos; Brasil; Infecções por HIV/tratamento farmacológico; Benzoxazinas/efeitos adversos

Palavras-chave

Dolutegravir; antiretroviral therapy; drug-related side effects and adverse reactions; efavirenz

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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por HIV / Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: Curr Med Res Opin Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido

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