학술논문

Long-term efavirenz use is associated with worse neurocognitive functioning in HIV-infected patients
Document Type
article
Source
Journal of NeuroVirology. 22(2)
Subject
Medical Microbiology
Biomedical and Clinical Sciences
Immunology
Infectious Diseases
Emerging Infectious Diseases
Chronic Liver Disease and Cirrhosis
Liver Disease
Hepatitis
HIV/AIDS
Digestive Diseases
Neurosciences
Clinical Research
Hepatitis - C
Mental Health
6.1 Pharmaceuticals
Evaluation of treatments and therapeutic interventions
Infection
Good Health and Well Being
Adult
Alkynes
Anti-HIV Agents
Benzoxazines
CD4 Lymphocyte Count
CD4-Positive T-Lymphocytes
Cognitive Dysfunction
Coinfection
Cyclopropanes
Drug Therapy
Combination
Executive Function
Female
HIV Infections
HIV-1
Hepacivirus
Hepatitis C
Humans
Lopinavir
Male
Memory
Middle Aged
Neuropsychological Tests
Ritonavir
Verbal Learning
Long-termantiretroviral therapy
Neurocognitive function
Efavirenz
Lopinavir/ritonavir
Neurotoxicity
Hepatitis C virus coinfection
CHARTER Group
Long-term antiretroviral therapy
Clinical Sciences
Virology
Clinical sciences
Medical microbiology
Language
Abstract
Neurocognitive (NC) complications continue to afflict a substantial proportion of HIV-infected people taking effective antiretroviral therapy (ART). One contributing mechanism for this is antiretroviral neurotoxicity. Efavirenz (EFV) is associated with short-term central nervous system (CNS) toxicity, but less is known about its long-term effects. Our objective was to compare NC functioning with long-term use of EFV to that of a comparator, lopinavir-ritonavir (LPV/r), in a cohort of well-characterized adults. Four hundred forty-five patients were selected from the CNS HIV Antiretroviral Therapy Effects Research (CHARTER) cohort based on their use of either EFV (n = 272, mean duration 17.9 months) or LPV/r (n = 173, mean duration 16.4 months) and the lack of severe NC comorbidities. All patients had undergone standardized comprehensive NC testing. Univariable and multivariable analyses to predict NC outcomes were performed. Compared with LPV/r users, EFV users were more likely to be taking their first ART regimen (p