Changes in Quality of Sleep, Mood, and Other Neuropsychiatric Symptoms After Switching Dolutegravir/Lamivudine/Abacavir to Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide in a Randomized Study of People With Human Immunodeficiency Virus With Poor Sleep Quality: GESIDA 10418

Cabello-Úbeda, Alfonso; Baeza, Alicia González; Troya, Jesús; Moral, S. de la Fuente; Mena, María Novella; Martínez, Adriana Pinto; Micán, Rafael; Górgolas, Miguel; Tascón, Guillermo Cuevas; Santiago, Alberto Díaz de; Morerno, José Sanz; Crestelo, David Rial; Arenzana, Carmen Busca; Serna, José Ignacio Bernardino de la; Almirón, Mariana Díaz; Cano, Joanna; Esteban, Herminia; Pérez‐Valero, Ignacio

doi:10.1093/ofid/ofac345

Cited by 8 publications

(3 citation statements)

References 19 publications

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“…Additionally, DRV, COBI, FTC, TAF was also associated with restless sleep. A recent randomized trial suggested favorable results on sleep quality and mood in people with insomnia switching from DTG, ABC, 3TC to DRV, COBI, FTC, TAF [56], however, this was an open-label study with a small, predominantly male population without depression. Moreover, PIs including DRV have been shown to interfere with oligodendrocyte maturation in vitro [57], and there is evidence to suggest an implication of these cells in the pathogenesis of depression [58].…”

Section: Discussionmentioning

confidence: 94%

Common antiretroviral combinations are associated with somatic depressive symptoms in women with HIV

Parra-Rodriguez,

O’Halloran,

Wang

et al. 2023

Aids

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Objective: While modern antiretroviral therapy (ART) is highly effective and safe, depressive symptoms have been associated with certain ART drugs. We examined the association between common ART regimens and depressive symptoms in women with HIV (WWH) with a focus on somatic vs. non-somatic symptoms. Design: Analysis of longitudinal data from the Women's Interagency HIV Study. Methods: Participants were classified into three groups based on the frequency of positive depression screening (CES-D ≥16): chronic depression (≥50% of visits since study enrollment), infrequent depression (<50% of visits), and never depressed (no visits). Novel Bayesian machine learning methods building upon a subset-tree kernel approach were developed to estimate the combined effects of ART regimens on depressive symptoms in each group after covariate adjustment. Results: The analysis included 1,538 WWH who participated in 12,924 (mean = 8.4) visits. The mean age was 49.9 years, 72% were Black, and 14% Hispanic. In the chronic depression group, combinations including tenofovir alafenamide and cobicistat-boosted elvitegravir and/or darunavir were associated with greater somatic symptoms of depression, whereas those combinations containing tenofovir disoproxil fumarate and efavirenz or rilpivirine were associated with less somatic depressive symptoms. ART was not associated with somatic symptoms in the infrequent depression or never depressed groups. ART regimens were not associated with non-somatic symptoms in any group. Conclusions: Specific ART combinations are associated with somatic depressive symptoms in WWH with chronic depression. Future studies should consider specific depressive symptoms domains as well as complete drug combinations when assessing the relationship between ART and depression.

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Section: Discussionmentioning

confidence: 94%

Common antiretroviral combinations are associated with somatic depressive symptoms in women with HIV

Parra-Rodriguez,

O’Halloran,

Wang

et al. 2023

Aids

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“…Furthermore, a recent randomized, multicenter, open-label study demonstrated notable improvements in sleep quality, mood, and neuropsychiatric symptoms among 72 patients who were switched from dolutegravir/lamivudine/abacavir to darunavir/cobicistat/emtricitabine/tenofovir alafenamide. It is important to interpret these findings carefully and continue to conduct further research to better understand the nuances of the neurological effects associated with different ART regimens [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors for Poor Sleep Quality in People Living with HIV: Preliminary Observations from an HIV Outpatient Clinic

Bruno,

Giotta,

Perelli

et al. 2023

Viruses

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Introduction: Sleep disorders have been reported in individuals living with HIV (PLWH), with a prevalence rate of over 50%. The main risk factors contributing to the development of sleep disturbances are not yet fully understood. We investigate the prevalence and risk factors associated with poor sleep quality in a population of PLWH who are receiving antiretroviral therapy (ART). Methods: The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality in PLWH attending our HIV Outpatient Clinic between October 2022 and April 2023. All subjects with a PSQI score > 5 were considered bad sleepers. A logistic regression analysis was carried out to assess risk factors associated with a PSQI score > 5. Results: A total of 132 PLWH (78% males) who received ART for at least one month were included in this observational study. The median age was 56 (IQR 47–61). Among all, 41 (31%) had a history of AIDS, and 95 (72%) were receiving an INSTI-based ART. The study population was divided into two groups: PSQI ≤ 5 (90; 68.2%) and PSQI > 5 (42; 31.8%). A lower BMI and the use of bictegravir in the current ART were associated with a PSQI score ≤ 5. In the multivariate analysis, the use of a bictegravir-based ART remained the only factor associated with better sleep quality (OR 0.17; p = 0.0222). No further associations between sleep disturbances and other epidemiological and clinical features were found. Conclusion: In this real-life scenario, poor sleep quality was observed in 31% of the cases, primarily among individuals with higher BMI. In addition, bictegravir users might seem to have a lower likelihood of experiencing poor sleep quality.

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“…However, DTG use has also been associated with neuropsychiatric symptoms and insomnia [114,115]. For PLWH with SD but not clinical insomnia, switching from DTG to a "non-neurotoxic" ART profile (darunavir/cobicistat/emtricitabine/tenofovir alafenamide) resulted in a significant improvement in subclinical SD and neuropsychiatric symptoms [116]. Shifting DTG dosing time to the morning was found to resolve SD for 75% (n = 39) of individuals who reported SD after initiating DTG at an outpatient clinic in Italy [117].…”

Section: The Role Of Art In Sleep Deficiency In Plwhmentioning

confidence: 99%

Sleep deficiency among people living with human immunodeficiency virus: A growing challenge

2023

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Purpose of reviewThe purpose of this narrative review is to consolidate and summarize the existing literature on sleep deficiency among people living with human immunodeficiency virus (HIV; PLWH), to discuss the potential impact of antiretroviral therapy on sleep deficiency and to identify priorities for future research in this area.Recent findingsThree important domains of sleep deficiency include alterations in sleep quality (including sleep disorders), duration and timing. The existing HIV and sleep deficiency literature, which is robust for sleep quality but sparser for sleep duration or sleep timing, has identified epidemiological correlates and outcomes associated with sleep deficiency including sociodemographic factors, HIV‐specific factors, aspects of physical and mental health and cognition.SummarySleep deficiency is a common problem among PLWH and is likely underdiagnosed, although more high‐quality research is needed in this area. Sleep quality has received the most attention in the literature via methodologies that assess subjective/self‐reported sleep quality, objective sleep quality or both. There is significantly less research on sleep duration and minimal research on sleep timing. Use of certain antiretroviral therapy drugs may be associated with sleep deficiency for some individuals. Future research should utilize larger, longitudinal studies with consistent, comprehensive and validated methods to assess both subjective and objective measures of sleep deficiency to better understand the prevalence, correlates and clinical implications of sleep deficiency in PLWH.

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Changes in Quality of Sleep, Mood, and Other Neuropsychiatric Symptoms After Switching Dolutegravir/Lamivudine/Abacavir to Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide in a Randomized Study of People With Human Immunodeficiency Virus With Poor Sleep Quality: GESIDA 10418

Cited by 8 publications

References 19 publications

Common antiretroviral combinations are associated with somatic depressive symptoms in women with HIV

Common antiretroviral combinations are associated with somatic depressive symptoms in women with HIV

Prevalence and Risk Factors for Poor Sleep Quality in People Living with HIV: Preliminary Observations from an HIV Outpatient Clinic

Sleep deficiency among people living with human immunodeficiency virus: A growing challenge

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