Abstract

MORAES, Rodrigo et al. Prevalence of Neuropsychiatric Adverse Effects in HIV Patients Treated with Dolutegravir. Medicina Interna [online]. 2019, vol.26, n.1, pp.14-20. ISSN 0872-671X.  https://doi.org/10.24950/rspmi/original/64/1/2019.

Introduction:Dolutegravir may be presented as a high efficiency level therapeutic option for naive or experimented patients, namely for simplifying therapies and achievement of a good interactions profile. Results of approval studies sustain it as safe and well tolerated. However, more recent studies have raised doubts on its safety profile, for instance at the neuropsychiatric effects developing level. Our aim was to determine prevalence of neuropsychiatric effects or no neuropsychiatric effects on a HIV infected patient population with dolutegravir on their antiretroviral therapy. Material and Methods: Transversal observational study of the cohort of patients followed at Oporto’s Hospital Immunodeficiency Department, subjected to dolutegravir therapy. After the introduction of dolutegravir, clinical files have been browsed and questionnaires have been placed for evaluation of adverse effects. Results: Seventy patients have been identified as under dolutegravir therapy, of which 7 have been excluded for lack of data. Five patients were naive as to antiretroviral therapy. Prevalence rate for neuropsychiatric effects and other effects was 20.6% and 25.4%, respectively. The main neuropsychiatric effects were insomnia, nervousness/anxiety and depressive humor, more frequently observed on female patients [(34.6% vs 10.8% of the men); OR 4.37; CI 95% 1.17-16.27; p = 0.028]. Despite the results, therapy has not been discontinued. Conclusion: Observation of a high rate of neuropsychiatric effects (20.6%), similar to a recently published study. However, these neuropsychiatric effects did not lead to the discontinuation of dolutegravir therapy on any patient. In spite of the limited resources at their disposal for this study, the authors strongly stress the need for further studies and evaluations of the real impact of neuropsychiatric effects somehow associated to dolutegravir.

Keywords : Anti-HIV Agents/adverse effects; Dolutegravir/adverse effects; HIV Infections/drug therapy; Mental Disorders/ chemically induced.

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