The
objective of the current study was to investigate symptoms of long-term central
nervous system (CNS) toxicity in HIV positive patients treated with EFV.
Researchers
at the Albion Street Centre in Sydney, Australia conducted a single-centre, cross-sectional
case-control study comparing patients treated with EFV for at least 6 months with
a matched control group.
Self-administered,
standardized questionnaires including the Depression, Anxiety and Stress Scales
(DASS), the Cognitive Failures Questionnaire (CFQ) and a questionnaire on unusual
dreams, insomnia, fatigue, dizziness, depersonalization and derealization were
administered to the study patients.
Results
•
Data for 32 matched pairs were analyzed.
•Significantly
higher total stress scores (P=0.008) were found in the EFV group.
•Of
the patients in this group, 19% also reported severe to extremely severe levels
of stress (P=0.014), indicating increased difficulty in relaxing, and being more
irritable, impatient, agitated and easily upset.
•Nineteen
per cent of patients treated with EFV also reported severe levels of anxiety (P=0.059)
as assessed with the DASS scale. This patient group also reported a higher rate
of unusual dreams (P=0.049).
•No
significant differences between groups were found for measures of cognitive impairments,
fatigue, dizziness, derealization or depersonalization.
In
conclusion, the authors write, "EFV-treated patients reported higher levels
of severe stress and anxiety as well as a higher rate of unusual dreams than patients
not treated with EFV. "
"These
differences may be an expression of persisting CNS side effects in patients who
remain on EFV for a prolonged period."
Albion
Street Centre, Sydney, Australia. tonia.rihs@medecine.unige.ch
1/19/07
Reference T
A Rihs, K Begley, D E Smith, and others. Efavirenz and chronic neuropsychiatric
symptoms: a cross-sectional case control study. HIV Medicine. 7(8): 544-548.
November 2006.
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