Neuropsychiatric manifestations among HIV-1 infected African patients receiving efavirenz-based cART with or without tuberculosis treatment containing rifampicin
Purpose Efavirenz-based combination antiretroviral therapy (cART) is associated with neuropsychiatric adverse events. We investigated the time to onset, duration, clinical implications, impact of pharmacogenetic variations, and anti-tuberculosis co-treatment on efavirenz-associated neuropsychiatric...
Gespeichert in:
| Veröffentlicht in: | European journal of clinical pharmacology 2018-11, Vol.74 (11), p.1405-1415 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1415 |
|---|---|
| container_issue | 11 |
| container_start_page | 1405 |
| container_title | European journal of clinical pharmacology |
| container_volume | 74 |
| creator | Mugusi, Sabina Ngaimisi, Eliford Janabi, Mohammed Mugusi, Ferdinand Minzi, Omary Aris, Eric Bakari, Muhammad Bertilsson, Leif Burhenne, Juergen Sandstrom, Eric Aklillu, Eleni |
| description | Purpose
Efavirenz-based combination antiretroviral therapy (cART) is associated with neuropsychiatric adverse events. We investigated the time to onset, duration, clinical implications, impact of pharmacogenetic variations, and anti-tuberculosis co-treatment on efavirenz-associated neuropsychiatric manifestations.
Methods
Prospective cohort study of cART naïve HIV patients with or without tuberculosis (HIV-TB) co-infection treated with efavirenz-based cART. Rifampicin-based anti-tuberculosis therapy was initiated 4 weeks prior to efavirenz-based cART in HIV-TB patients. Data on demographic, clinical, laboratory, and a 29-item questionnaire on neuropsychiatric manifestations were collected for 16 weeks after cART initiation. Genotyping for
CYP2B6
,
CYP3A5
,
SLCO1B1
, and
ABCB1
and quantification of efavirenz plasma concentration were done on the 4th and 16th week.
Results
Data from 458 patients (243 HIV-only and 215 HIV-TB) were analyzed. Overall incidence of neuropsychiatric manifestations was 57.6% being higher in HIV-only (66.7%) compared to HIV-TB patients (47.4%) (
p
|
| doi_str_mv | 10.1007/s00228-018-2499-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_487009</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2068654692</sourcerecordid><originalsourceid>FETCH-LOGICAL-c558t-98a878eeb4887284d4d16b8b4c31bdb003543bd1cd71bd7fe19b4b6ec138c20a3</originalsourceid><addsrcrecordid>eNp1ks1u1DAUhSMEokPhAdggS2zYGGzHSZwN0qgCWqkCCRW2luPczLhM7GA7U5W34U25w0xbitSVf-53jn3tUxQvOXvLGWveJcaEUJRxRYVsW8oeFQsuS0E5k_xxsWCs5LRuG3ZUPEvpkjFetax8WhyVDEuiqRbF788wxzCla7t2JkdnyWi8GyBlk13wiZgx-BU5PftOOXF-AJuhJ8sBSePJhBD4nEgEC27rkITBbF0E_4t2JiFql18vyJXLaxLi3zHMmeS5g2jnTUgukRzB5BFtiA0-G-d3NtENZpycdf558WQwmwQvDuNx8e3jh4uTU3r-5dPZyfKc2qpSmbbKqEYBdFKpRijZy57XneqkLXnXd9hvJcuu57ZvcN0MwNtOdjVYXiormCmPC7r3TVcwzZ2eohtNvNbBOH3Y-oEz0FI1jLXItw_yUwz9nehGyCX-QFnXO-37vRaBEXqLzUezuW9xr-LdWq_CVtdciapVaPDmYBDDzxl_S48uWdhsjIcwJy1Yw0TFuSgRff0fehnm6PEpkapVXcm6FUjxPWVjSCnCcHsZzvQubHofNo1h07uwaYaaV_92cau4SRcC4vBEWPIriHdHP-z6B5zG5f4</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2068654692</pqid></control><display><type>article</type><title>Neuropsychiatric manifestations among HIV-1 infected African patients receiving efavirenz-based cART with or without tuberculosis treatment containing rifampicin</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>SWEPUB Freely available online</source><creator>Mugusi, Sabina ; Ngaimisi, Eliford ; Janabi, Mohammed ; Mugusi, Ferdinand ; Minzi, Omary ; Aris, Eric ; Bakari, Muhammad ; Bertilsson, Leif ; Burhenne, Juergen ; Sandstrom, Eric ; Aklillu, Eleni</creator><creatorcontrib>Mugusi, Sabina ; Ngaimisi, Eliford ; Janabi, Mohammed ; Mugusi, Ferdinand ; Minzi, Omary ; Aris, Eric ; Bakari, Muhammad ; Bertilsson, Leif ; Burhenne, Juergen ; Sandstrom, Eric ; Aklillu, Eleni</creatorcontrib><description>Purpose
Efavirenz-based combination antiretroviral therapy (cART) is associated with neuropsychiatric adverse events. We investigated the time to onset, duration, clinical implications, impact of pharmacogenetic variations, and anti-tuberculosis co-treatment on efavirenz-associated neuropsychiatric manifestations.
Methods
Prospective cohort study of cART naïve HIV patients with or without tuberculosis (HIV-TB) co-infection treated with efavirenz-based cART. Rifampicin-based anti-tuberculosis therapy was initiated 4 weeks prior to efavirenz-based cART in HIV-TB patients. Data on demographic, clinical, laboratory, and a 29-item questionnaire on neuropsychiatric manifestations were collected for 16 weeks after cART initiation. Genotyping for
CYP2B6
,
CYP3A5
,
SLCO1B1
, and
ABCB1
and quantification of efavirenz plasma concentration were done on the 4th and 16th week.
Results
Data from 458 patients (243 HIV-only and 215 HIV-TB) were analyzed. Overall incidence of neuropsychiatric manifestations was 57.6% being higher in HIV-only (66.7%) compared to HIV-TB patients (47.4%) (
p
< 0.01). HIV-only patients were more symptomatic, with proportionately higher grades of manifestations compared to HIV-TB patients. Median time to manifestations was 1 week after cART initiation in HIV-only and 6 weeks after anti-TB (i.e., 2 weeks after cART initiation) in HIV-TB patients. HIV-only patients had significantly higher efavirenz plasma concentrations at 4 weeks after cART compared to HIV-TB patients. No association of sex or genotype was seen in relation to neuropsychiatric manifestations. Risk for neuropsychiatric manifestations was three times more in HIV-only patients compared to HIV-TB (
p
< 0.01).
Conclusions
Incidence of neuropsychiatric manifestations during early initiation of efavirenz-based cART is high in Tanzanian HIV patients. Risk of neuropsychiatric manifestations is lower in HIV patients co-treated with rifampicin containing anti-TB compared to those treated with efavirenz-based cART only.</description><identifier>ISSN: 0031-6970</identifier><identifier>ISSN: 1432-1041</identifier><identifier>EISSN: 1432-1041</identifier><identifier>DOI: 10.1007/s00228-018-2499-0</identifier><identifier>PMID: 30003275</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Africa South of the Sahara ; Anti-HIV Agents - administration & dosage ; Anti-HIV Agents - adverse effects ; Antibiotics, Antitubercular - administration & dosage ; Antibiotics, Antitubercular - adverse effects ; Antiretroviral agents ; Antiretroviral drugs ; Antiretroviral therapy ; Antiretroviral Therapy, Highly Active - adverse effects ; Antiretroviral Therapy, Highly Active - methods ; Antitubercular Agents - therapeutic use ; Benzoxazines - administration & dosage ; Benzoxazines - adverse effects ; Benzoxazines - blood ; Biomedical and Life Sciences ; Biomedicine ; Cohort Studies ; Demographics ; Efavirenz ; Female ; Genotype ; Genotyping ; Health risks ; HIV ; HIV Infections - blood ; HIV Infections - drug therapy ; HIV Infections - genetics ; HIV Infections - microbiology ; HIV-1 - isolation & purification ; Human immunodeficiency virus ; Humans ; Incidence ; Male ; Medicin och hälsovetenskap ; Mental Disorders - blood ; Mental Disorders - chemically induced ; Mental Disorders - genetics ; Mental Disorders - microbiology ; Patients ; Pharmacogenetics ; Pharmacology/Toxicology ; Prospective Studies ; Rifampin ; Rifampin - administration & dosage ; Rifampin - adverse effects ; Tuberculosis ; Tuberculosis - blood ; Tuberculosis - drug therapy ; Tuberculosis - genetics ; Tuberculosis - microbiology</subject><ispartof>European journal of clinical pharmacology, 2018-11, Vol.74 (11), p.1405-1415</ispartof><rights>The Author(s) 2018</rights><rights>European Journal of Clinical Pharmacology is a copyright of Springer, (2018). All Rights Reserved. © 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c558t-98a878eeb4887284d4d16b8b4c31bdb003543bd1cd71bd7fe19b4b6ec138c20a3</citedby><cites>FETCH-LOGICAL-c558t-98a878eeb4887284d4d16b8b4c31bdb003543bd1cd71bd7fe19b4b6ec138c20a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00228-018-2499-0$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00228-018-2499-0$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30003275$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:140013669$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Mugusi, Sabina</creatorcontrib><creatorcontrib>Ngaimisi, Eliford</creatorcontrib><creatorcontrib>Janabi, Mohammed</creatorcontrib><creatorcontrib>Mugusi, Ferdinand</creatorcontrib><creatorcontrib>Minzi, Omary</creatorcontrib><creatorcontrib>Aris, Eric</creatorcontrib><creatorcontrib>Bakari, Muhammad</creatorcontrib><creatorcontrib>Bertilsson, Leif</creatorcontrib><creatorcontrib>Burhenne, Juergen</creatorcontrib><creatorcontrib>Sandstrom, Eric</creatorcontrib><creatorcontrib>Aklillu, Eleni</creatorcontrib><title>Neuropsychiatric manifestations among HIV-1 infected African patients receiving efavirenz-based cART with or without tuberculosis treatment containing rifampicin</title><title>European journal of clinical pharmacology</title><addtitle>Eur J Clin Pharmacol</addtitle><addtitle>Eur J Clin Pharmacol</addtitle><description>Purpose
Efavirenz-based combination antiretroviral therapy (cART) is associated with neuropsychiatric adverse events. We investigated the time to onset, duration, clinical implications, impact of pharmacogenetic variations, and anti-tuberculosis co-treatment on efavirenz-associated neuropsychiatric manifestations.
Methods
Prospective cohort study of cART naïve HIV patients with or without tuberculosis (HIV-TB) co-infection treated with efavirenz-based cART. Rifampicin-based anti-tuberculosis therapy was initiated 4 weeks prior to efavirenz-based cART in HIV-TB patients. Data on demographic, clinical, laboratory, and a 29-item questionnaire on neuropsychiatric manifestations were collected for 16 weeks after cART initiation. Genotyping for
CYP2B6
,
CYP3A5
,
SLCO1B1
, and
ABCB1
and quantification of efavirenz plasma concentration were done on the 4th and 16th week.
Results
Data from 458 patients (243 HIV-only and 215 HIV-TB) were analyzed. Overall incidence of neuropsychiatric manifestations was 57.6% being higher in HIV-only (66.7%) compared to HIV-TB patients (47.4%) (
p
< 0.01). HIV-only patients were more symptomatic, with proportionately higher grades of manifestations compared to HIV-TB patients. Median time to manifestations was 1 week after cART initiation in HIV-only and 6 weeks after anti-TB (i.e., 2 weeks after cART initiation) in HIV-TB patients. HIV-only patients had significantly higher efavirenz plasma concentrations at 4 weeks after cART compared to HIV-TB patients. No association of sex or genotype was seen in relation to neuropsychiatric manifestations. Risk for neuropsychiatric manifestations was three times more in HIV-only patients compared to HIV-TB (
p
< 0.01).
Conclusions
Incidence of neuropsychiatric manifestations during early initiation of efavirenz-based cART is high in Tanzanian HIV patients. Risk of neuropsychiatric manifestations is lower in HIV patients co-treated with rifampicin containing anti-TB compared to those treated with efavirenz-based cART only.</description><subject>Adult</subject><subject>Africa South of the Sahara</subject><subject>Anti-HIV Agents - administration & dosage</subject><subject>Anti-HIV Agents - adverse effects</subject><subject>Antibiotics, Antitubercular - administration & dosage</subject><subject>Antibiotics, Antitubercular - adverse effects</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral drugs</subject><subject>Antiretroviral therapy</subject><subject>Antiretroviral Therapy, Highly Active - adverse effects</subject><subject>Antiretroviral Therapy, Highly Active - methods</subject><subject>Antitubercular Agents - therapeutic use</subject><subject>Benzoxazines - administration & dosage</subject><subject>Benzoxazines - adverse effects</subject><subject>Benzoxazines - blood</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cohort Studies</subject><subject>Demographics</subject><subject>Efavirenz</subject><subject>Female</subject><subject>Genotype</subject><subject>Genotyping</subject><subject>Health risks</subject><subject>HIV</subject><subject>HIV Infections - blood</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - genetics</subject><subject>HIV Infections - microbiology</subject><subject>HIV-1 - isolation & purification</subject><subject>Human immunodeficiency virus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Medicin och hälsovetenskap</subject><subject>Mental Disorders - blood</subject><subject>Mental Disorders - chemically induced</subject><subject>Mental Disorders - genetics</subject><subject>Mental Disorders - microbiology</subject><subject>Patients</subject><subject>Pharmacogenetics</subject><subject>Pharmacology/Toxicology</subject><subject>Prospective Studies</subject><subject>Rifampin</subject><subject>Rifampin - administration & dosage</subject><subject>Rifampin - adverse effects</subject><subject>Tuberculosis</subject><subject>Tuberculosis - blood</subject><subject>Tuberculosis - drug therapy</subject><subject>Tuberculosis - genetics</subject><subject>Tuberculosis - microbiology</subject><issn>0031-6970</issn><issn>1432-1041</issn><issn>1432-1041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>D8T</sourceid><recordid>eNp1ks1u1DAUhSMEokPhAdggS2zYGGzHSZwN0qgCWqkCCRW2luPczLhM7GA7U5W34U25w0xbitSVf-53jn3tUxQvOXvLGWveJcaEUJRxRYVsW8oeFQsuS0E5k_xxsWCs5LRuG3ZUPEvpkjFetax8WhyVDEuiqRbF788wxzCla7t2JkdnyWi8GyBlk13wiZgx-BU5PftOOXF-AJuhJ8sBSePJhBD4nEgEC27rkITBbF0E_4t2JiFql18vyJXLaxLi3zHMmeS5g2jnTUgukRzB5BFtiA0-G-d3NtENZpycdf558WQwmwQvDuNx8e3jh4uTU3r-5dPZyfKc2qpSmbbKqEYBdFKpRijZy57XneqkLXnXd9hvJcuu57ZvcN0MwNtOdjVYXiormCmPC7r3TVcwzZ2eohtNvNbBOH3Y-oEz0FI1jLXItw_yUwz9nehGyCX-QFnXO-37vRaBEXqLzUezuW9xr-LdWq_CVtdciapVaPDmYBDDzxl_S48uWdhsjIcwJy1Yw0TFuSgRff0fehnm6PEpkapVXcm6FUjxPWVjSCnCcHsZzvQubHofNo1h07uwaYaaV_92cau4SRcC4vBEWPIriHdHP-z6B5zG5f4</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Mugusi, Sabina</creator><creator>Ngaimisi, Eliford</creator><creator>Janabi, Mohammed</creator><creator>Mugusi, Ferdinand</creator><creator>Minzi, Omary</creator><creator>Aris, Eric</creator><creator>Bakari, Muhammad</creator><creator>Bertilsson, Leif</creator><creator>Burhenne, Juergen</creator><creator>Sandstrom, Eric</creator><creator>Aklillu, Eleni</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20181101</creationdate><title>Neuropsychiatric manifestations among HIV-1 infected African patients receiving efavirenz-based cART with or without tuberculosis treatment containing rifampicin</title><author>Mugusi, Sabina ; Ngaimisi, Eliford ; Janabi, Mohammed ; Mugusi, Ferdinand ; Minzi, Omary ; Aris, Eric ; Bakari, Muhammad ; Bertilsson, Leif ; Burhenne, Juergen ; Sandstrom, Eric ; Aklillu, Eleni</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c558t-98a878eeb4887284d4d16b8b4c31bdb003543bd1cd71bd7fe19b4b6ec138c20a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Africa South of the Sahara</topic><topic>Anti-HIV Agents - administration & dosage</topic><topic>Anti-HIV Agents - adverse effects</topic><topic>Antibiotics, Antitubercular - administration & dosage</topic><topic>Antibiotics, Antitubercular - adverse effects</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral drugs</topic><topic>Antiretroviral therapy</topic><topic>Antiretroviral Therapy, Highly Active - adverse effects</topic><topic>Antiretroviral Therapy, Highly Active - methods</topic><topic>Antitubercular Agents - therapeutic use</topic><topic>Benzoxazines - administration & dosage</topic><topic>Benzoxazines - adverse effects</topic><topic>Benzoxazines - blood</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cohort Studies</topic><topic>Demographics</topic><topic>Efavirenz</topic><topic>Female</topic><topic>Genotype</topic><topic>Genotyping</topic><topic>Health risks</topic><topic>HIV</topic><topic>HIV Infections - blood</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - genetics</topic><topic>HIV Infections - microbiology</topic><topic>HIV-1 - isolation & purification</topic><topic>Human immunodeficiency virus</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Medicin och hälsovetenskap</topic><topic>Mental Disorders - blood</topic><topic>Mental Disorders - chemically induced</topic><topic>Mental Disorders - genetics</topic><topic>Mental Disorders - microbiology</topic><topic>Patients</topic><topic>Pharmacogenetics</topic><topic>Pharmacology/Toxicology</topic><topic>Prospective Studies</topic><topic>Rifampin</topic><topic>Rifampin - administration & dosage</topic><topic>Rifampin - adverse effects</topic><topic>Tuberculosis</topic><topic>Tuberculosis - blood</topic><topic>Tuberculosis - drug therapy</topic><topic>Tuberculosis - genetics</topic><topic>Tuberculosis - microbiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mugusi, Sabina</creatorcontrib><creatorcontrib>Ngaimisi, Eliford</creatorcontrib><creatorcontrib>Janabi, Mohammed</creatorcontrib><creatorcontrib>Mugusi, Ferdinand</creatorcontrib><creatorcontrib>Minzi, Omary</creatorcontrib><creatorcontrib>Aris, Eric</creatorcontrib><creatorcontrib>Bakari, Muhammad</creatorcontrib><creatorcontrib>Bertilsson, Leif</creatorcontrib><creatorcontrib>Burhenne, Juergen</creatorcontrib><creatorcontrib>Sandstrom, Eric</creatorcontrib><creatorcontrib>Aklillu, Eleni</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>European journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mugusi, Sabina</au><au>Ngaimisi, Eliford</au><au>Janabi, Mohammed</au><au>Mugusi, Ferdinand</au><au>Minzi, Omary</au><au>Aris, Eric</au><au>Bakari, Muhammad</au><au>Bertilsson, Leif</au><au>Burhenne, Juergen</au><au>Sandstrom, Eric</au><au>Aklillu, Eleni</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neuropsychiatric manifestations among HIV-1 infected African patients receiving efavirenz-based cART with or without tuberculosis treatment containing rifampicin</atitle><jtitle>European journal of clinical pharmacology</jtitle><stitle>Eur J Clin Pharmacol</stitle><addtitle>Eur J Clin Pharmacol</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>74</volume><issue>11</issue><spage>1405</spage><epage>1415</epage><pages>1405-1415</pages><issn>0031-6970</issn><issn>1432-1041</issn><eissn>1432-1041</eissn><abstract>Purpose
Efavirenz-based combination antiretroviral therapy (cART) is associated with neuropsychiatric adverse events. We investigated the time to onset, duration, clinical implications, impact of pharmacogenetic variations, and anti-tuberculosis co-treatment on efavirenz-associated neuropsychiatric manifestations.
Methods
Prospective cohort study of cART naïve HIV patients with or without tuberculosis (HIV-TB) co-infection treated with efavirenz-based cART. Rifampicin-based anti-tuberculosis therapy was initiated 4 weeks prior to efavirenz-based cART in HIV-TB patients. Data on demographic, clinical, laboratory, and a 29-item questionnaire on neuropsychiatric manifestations were collected for 16 weeks after cART initiation. Genotyping for
CYP2B6
,
CYP3A5
,
SLCO1B1
, and
ABCB1
and quantification of efavirenz plasma concentration were done on the 4th and 16th week.
Results
Data from 458 patients (243 HIV-only and 215 HIV-TB) were analyzed. Overall incidence of neuropsychiatric manifestations was 57.6% being higher in HIV-only (66.7%) compared to HIV-TB patients (47.4%) (
p
< 0.01). HIV-only patients were more symptomatic, with proportionately higher grades of manifestations compared to HIV-TB patients. Median time to manifestations was 1 week after cART initiation in HIV-only and 6 weeks after anti-TB (i.e., 2 weeks after cART initiation) in HIV-TB patients. HIV-only patients had significantly higher efavirenz plasma concentrations at 4 weeks after cART compared to HIV-TB patients. No association of sex or genotype was seen in relation to neuropsychiatric manifestations. Risk for neuropsychiatric manifestations was three times more in HIV-only patients compared to HIV-TB (
p
< 0.01).
Conclusions
Incidence of neuropsychiatric manifestations during early initiation of efavirenz-based cART is high in Tanzanian HIV patients. Risk of neuropsychiatric manifestations is lower in HIV patients co-treated with rifampicin containing anti-TB compared to those treated with efavirenz-based cART only.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30003275</pmid><doi>10.1007/s00228-018-2499-0</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-6970 |
| ispartof | European journal of clinical pharmacology, 2018-11, Vol.74 (11), p.1405-1415 |
| issn | 0031-6970 1432-1041 1432-1041 |
| language | eng |
| recordid | cdi_swepub_primary_oai_swepub_ki_se_487009 |
| source | MEDLINE; SpringerLink Journals; SWEPUB Freely available online |
| subjects | Adult Africa South of the Sahara Anti-HIV Agents - administration & dosage Anti-HIV Agents - adverse effects Antibiotics, Antitubercular - administration & dosage Antibiotics, Antitubercular - adverse effects Antiretroviral agents Antiretroviral drugs Antiretroviral therapy Antiretroviral Therapy, Highly Active - adverse effects Antiretroviral Therapy, Highly Active - methods Antitubercular Agents - therapeutic use Benzoxazines - administration & dosage Benzoxazines - adverse effects Benzoxazines - blood Biomedical and Life Sciences Biomedicine Cohort Studies Demographics Efavirenz Female Genotype Genotyping Health risks HIV HIV Infections - blood HIV Infections - drug therapy HIV Infections - genetics HIV Infections - microbiology HIV-1 - isolation & purification Human immunodeficiency virus Humans Incidence Male Medicin och hälsovetenskap Mental Disorders - blood Mental Disorders - chemically induced Mental Disorders - genetics Mental Disorders - microbiology Patients Pharmacogenetics Pharmacology/Toxicology Prospective Studies Rifampin Rifampin - administration & dosage Rifampin - adverse effects Tuberculosis Tuberculosis - blood Tuberculosis - drug therapy Tuberculosis - genetics Tuberculosis - microbiology |
| title | Neuropsychiatric manifestations among HIV-1 infected African patients receiving efavirenz-based cART with or without tuberculosis treatment containing rifampicin |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-02T11%3A48%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_swepu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Neuropsychiatric%20manifestations%20among%20HIV-1%20infected%20African%20patients%20receiving%20efavirenz-based%20cART%20with%20or%20without%20tuberculosis%20treatment%20containing%20rifampicin&rft.jtitle=European%20journal%20of%20clinical%20pharmacology&rft.au=Mugusi,%20Sabina&rft.date=2018-11-01&rft.volume=74&rft.issue=11&rft.spage=1405&rft.epage=1415&rft.pages=1405-1415&rft.issn=0031-6970&rft.eissn=1432-1041&rft_id=info:doi/10.1007/s00228-018-2499-0&rft_dat=%3Cproquest_swepu%3E2068654692%3C/proquest_swepu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2068654692&rft_id=info:pmid/30003275&rfr_iscdi=true |