Anxiety, depression, and sleep disturbances among people on long-term efavirenz-based treatment for HIV

BMC PsychiatryScott Cunningham MD PhD, et al. | November 17, 2022



It has been estimated that neuropsychiatric disorders, especially anxiety, depression, and insomnia, are 7-fold higher in people living with HIV than the general population not infected with HIV.

Although the cause(s) of neuropsychiatric disorders among people living with HIV may be due to HIV neurotoxicity, recreational drug use, the stigma of HIV, social isolation, and/or treatment-associated side effects, use of EFV has been reported to cause adverse effects in up to 70% of people living with HIV.

The current study showed that EFV-associated side effects were persistent, common, and independent of duration of treatment or CD4+ T-cell count.

This was a cross-sectional, single-center study involving people living with HIV (n=424) on long-term EFV-based anti-retroviral therapy.

The study participants were divided into the following 4 treatment groups: 0.5 y < EFV < 2 y; 2 y < EFV < 4 y; 4 y < EFV < 6 y; and EFV > 6 y.

Untoward neuropsychiatric side effects were assessed by administering the following instruments to the study participants: 12-item Short Form Health Survey; Hospital Anxiety and Depression Scale; and Pittsburgh Sleep Quality Index.

The 12-item Short Form Health Survey mental component summary score among people living with HIV was 50.2, which was lower than the general population.

The prevalence of anxiety, depression, and sleep disturbances among people living with HIV was 15.6%, 15.3%, and 58%, respectively.

The untoward neuropsychiatric side effects were time- and CD4+ T-cell count-independent.