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Efavirenz is related to neuropsychiatric symptoms among adults, but not among adolescents living with human immunodeficiency virus in Kilimanjaro, Tanzania
Author(s) -
Sumaride Boer Marion,
Schellekens Arnt,
Duinmaijer Ashanti,
Lalashowi Julieth M.,
Swai Happiness J.,
Mast Quirijn,
der Ven Andre,
Kinabo Grace
Publication year - 2018
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13021
Subject(s) - tanzania , efavirenz , depression (economics) , medicine , psychiatry , hospital anxiety and depression scale , human immunodeficiency virus (hiv) , anxiety , viral load , antiretroviral therapy , immunology , environmental science , economics , macroeconomics , environmental planning
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.