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

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.

Highly active antiretroviral therapy-silver nanoparticle conjugate interacts with neuronal and glial cells and alleviates anxiety-like behaviour in streptozotocin-induced diabetic rats

“…Excessive production of proin ammatory cytokines during neuroin ammation have been implicated in cognitive de cits and anxiety disorders (Charlton et al, 2018;Li et al, 2019). Interestingly, in the post-era of HAART, people living with HIV have experienced an improvement in motor skills and verbal uency but show impaired executive functions and anxiety-like behaviour (Checa et al, 2020;Heaton et al, 2011). In addition, the prevalence of anxiety and depression among the patient receiving HAART remains high (Nuesch et al, 2009;Rabkin et al, 2000).…”

“…In addition, the prevalence of anxiety and depression among the patient receiving HAART remains high (Nuesch et al, 2009;Rabkin et al, 2000). The most used components of HAART (Efavirenz and Tenofovir) have been reported to cross the blood-brain barrier, causing mitochondrial dysfunction and some neurological-related adverse effects like depression and anxiety disorder (Checa et al, 2020;Chen et al, 2019). Several studies have suggested that the prefrontal cortex and its circuitry play a vital role in anxiety-like behaviour in animals and humans (Hare & Duman, 2020;Likhtik et al, 2014).…”

Highly active antiretroviral therapy-silver nanoparticle conjugate interacts with neuronal and glial cells and alleviates anxiety-like behaviour in streptozotocin-induced diabetic rats

“…Excessive production of pro-inflammatory cytokines during neuroinflammation has been implicated in cognitive deficits and anxiety disorders ( Charlton et al, 2018 , Li et al, 2019 ). Interestingly, in the post-era of HAART, people living with HIV have experienced an improvement in motor skills and verbal fluency but show impaired executive functions and anxiety-like behaviour ( Heaton et al, 2011 , Checa et al, 2020 ). In addition, the prevalence of anxiety and depression among the patient receiving HAART remains high ( Nuesch et al, 2009 , Rabkin et al, 2000 ).…”

Highly Active Antiretroviral Therapy-silver Nanoparticle Conjugate Alleviates Anxiety-like Behaviour in Streptozotocin-induced Diabetic Rats

“…Interestingly, in the post-era of HAART, people living with HIV have experienced an improvement in motor skills, verbal fluency, but executive functions and anxiety-like behaviour remain dominant impairments (Checa et al, 2020;Heaton et al, 2011). In addition, the prevalence of anxiety and depression among the patient receiving HAART remains high (Nuesch et al, 2009;Rabkin et al, 2000).…”

“…In addition, the prevalence of anxiety and depression among the patient receiving HAART remains high (Nuesch et al, 2009;Rabkin et al, 2000). The most used components of HAART (Efavirenz and Tenofovir) have been reported to cross the blood-brain barrier, causing mitochondrial dysfunction and some neurological-related adverse effects like depression and anxiety disorder (Checa et al, 2020;Chen et al, 2019). Several studies have suggested that the prefrontal cortex and its circuitry play a vital role in anxiety-like behaviour in animals and humans (Hare & Duman, 2020;Likhtik et al, 2014).…”