Depression is associated with efavirenz-containing treatments in newly antiretroviral therapy initiated HIV patients in Ecuador

AIDS Res Ther. 2020 Jul 29;17(1):47. doi: 10.1186/s12981-020-00303-1.

Abstract

Background: It is well known that people living with HIV (PLWH) is in higher risk for the development of depression and it has also been suggested that the use of efavirenz into the antiretroviral regimens increases even that risk.

Objective: To evaluate the effect of efavirenz-containing antiretroviral regimens on the development of depression in newly ART initiated HIV patients in Ecuador.

Methods: In a prospective cohort study from June 2016 to May 2017, all newly HIV diagnosed patients at the HIV/AIDS Unit of the Hospital Eugenio Espejo in Quito, Ecuador were evaluated using the Hamilton Rating Scale for Depression followed by a second assessment 8-12 weeks after antiretroviral therapy containing efavirenz was initiated.

Results: A total of 79 patients, mainly males younger than 35 years were studied. Majority of them were on TDF/FTC/EFV. Initial score in Hamilton Rating Scale revealed that less than 30% had no depression symptoms while almost 40% had mild depression. However, in the second assessment, 22.6% of the subjects had a score in the Hamilton Rating Scale compatible with severe or very severe depression (RR 1.58, 95% CI 1.09 to 2.28; p = 0.05).

Conclusion: In our cohort study, depression was much higher in patients on Efavirenz-containing treatments. Therefore, assessment for depression must be essential as part of follow-up in these patients.

Keywords: Depression; Efavirenz; HIV; Hamilton Rating Scale for Depression; Newly diagnose.

MeSH terms

  • Adult
  • Alkynes / adverse effects*
  • Anti-HIV Agents / adverse effects
  • Benzoxazines / adverse effects*
  • Cyclopropanes / adverse effects*
  • Depression / chemically induced*
  • Depression / classification
  • Depression / epidemiology*
  • Ecuador / epidemiology
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • Humans
  • Male
  • Prospective Studies
  • Reverse Transcriptase Inhibitors / adverse effects*
  • Young Adult

Substances

  • Alkynes
  • Anti-HIV Agents
  • Benzoxazines
  • Cyclopropanes
  • Reverse Transcriptase Inhibitors
  • efavirenz