Efavirenz is related to neuropsychiatric symptoms among adults, but not among adolescents living with human immunodeficiency virus in Kilimanjaro, Tanzania

• Published in: Tropical medicine & international health 2018-02, Vol.23 (2), p.164-172
• Main Authors: Sumari‐de Boer, Marion, Schellekens, Arnt, Duinmaijer, Ashanti, Lalashowi, Julieth M., Swai, Happiness J., Mast, Quirijn, der Ven, Andre, Kinabo, Grace
• Format: Article
• Language: English
• Subjects: Adolescents; Adults; Alcohol use; Alcohols; Antiretroviral agents; Antiretroviral drugs; Anxiety; cross‐sectional study; Efavirenz; Health care facilities; HIV; Human immunodeficiency virus; Mental depression; neuropsychiatric symptoms; Statistical tests; Symptoms; symptômes neuropsychiatriques; Tanzania; Tanzanie; Teenagers; VIH; Viruses; étude transversale
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.13021

Objectives To explore the relationship between Efavirenz (EFV) and neuropsychiatric symptoms among adults and adolescents living with human immunodeficiency virus (HIV) in Kilimanjaro, Tanzania. Methods Cross‐sectional study among HIV‐infected adults (age 18–65) and adolescents (age 12–17) on antiretroviral treatment attending Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Neuropsychiatric symptoms were measured using the Hospital Anxiety and Depression Scale (HADS), the Symptom Checklist 90 (SCL‐90) and the Mini‐International Neuropsychiatric Interview (MINI). manova and chi‐squared tests were used to test differences between EFV and non‐EFV‐treated participants. Results A total of 215 adults and 150 adolescents participated. About 52% of adults and 37% of adolescents used EFV. Among adults, depression scores were higher for those on EFV (HADS (Cohen's D: 0.38; P = 0.02) and SCL‐90 (Cohen's D: 0.24; P = 0.03). Among adolescents, those on EFV had lower scores on depression (HADS (Cohen's D: 0.3; P = 0.02) and SCL‐90 (Cohen's D: 0.1; P = 0.02). About 10% of adults reported suicidal thoughts, but there was no difference between those on EFV and those without. Lastly, adults on EFV reported higher levels of problematic alcohol use (P = 0.003). Conclusions In line with the previous studies, EFV is associated with depressive symptoms and problematic alcohol use among HIV‐infected adults in Tanzania. In contrast, EFV was associated with lower levels of depressive symptoms in adolescents in Tanzania. Particularly among adults, close monitoring of depressive symptoms and alcohol use is indicated. Objectifs Explorer l'association entre l'efavirenz (EFV) et les symptômes neuropsychiatriques chez les adultes et les adolescents vivant avec le VIH dans le Kilimandjaro, en Tanzanie. Méthodes Etude transversale chez des adultes infectés par le VIH (âgés de 18 à 65 ans) et des adolescents (âgés de 12 à 17 ans) sous ART, visitant le Kilimanjaro Christian Medical Center (KCMC), à Moshi, en Tanzanie. Les symptômes neuropsychiatriques ont été mesurés à l'aide de l'Echelle d'Anxiété et de Dépression de l'Hôpital (HADS), la liste de contrôle 90 des symptômes (SCL‐90) et la Mini interview Neuropsychiatrique Internationale (MINI). MANOVA et les tests X2 ont été utilisés pour tester les différences entre les participants traités et non‐traités avec l’EFV. Résultats 215 adultes et 150 adolescents ont participé. 52% des adultes et 37% des adolescents utilisaient l’EFV. Chez