Central nervous system disorders after use of dolutegravir: evidence from preclinical and clinical studies

Jakimiuk, Alicja; Piechal, Agnieszka; Wiercińska-Drapało, Alicja; Nowaczyk, Alicja; Mirowska-Guzel, Dagmara

doi:10.1007/s43440-023-00515-y

Cited by 5 publications

(1 citation statement)

References 85 publications

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“…Regarding the association between Dolutegravir and PTSD, in contrast to our findings, a study carried out on over 500 women with HIV did not show a correlation between worsening of PTSD scores following the start or switch to therapy with Dolutegravir, while a worsening was found following a switch to therapy containing Raltegravir [ 45 ]. The mechanisms by which DTG can cause psychiatric disorders are not known, but the available studies suggest a multifactorial genesis that also includes genetic factors [ 46 ]. In line with these findings, our study supports the need to constantly monitor MH among PLWH receiving DTG-based regimens, especially in consideration of its widespread use and the increased risk of developing the MD described in this population.…”

Section: Discussionmentioning

confidence: 99%

Stigma and mental health among people living with HIV across the COVID-19 pandemic: a cross-sectional study

Di Gennaro,

Papagni,

Segala

et al. 2024

BMC Infect Dis

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Background Mental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact – although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) – PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy. Methods From January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model. Results 578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06–4.35]), family stigma (2.42 [1.65–3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder. Conclusions In this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.

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Section: Discussionmentioning

confidence: 99%