Risk of clinically significant depression in HIV‐infected patients: effect of antiretroviral drugs1. Issue 4 (11th November 2013)

• Record Type: Journal Article
• Authors: Gutiérrez, F; García, L; Padilla, S; Álvarez, D; Moreno, S; Navarro, G; Gómez‐Sirvent, JL; Vidal, F; Asensi, V; Masiá, M
• Is Part Of: HIV medicine. Volume 15:Issue 4(2014:Apr.)
• Page Start: 213
• Page End: 223
• Publication Date: 2013-11-11
• Subjects: HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12104
• Languages: English
• ISSNs: 1464-2662

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hiv12104-sec-0001" sec-type="section"> <title>Objectives</title> <p>We aimed to characterize depression in newly diagnosed HIV‐infected patients, to determine the effect of antiretroviral therapy (ART) on its incidence, and to investigate whether efavirenz use was associated with a higher risk, compared with non‐efavirenz‐containing regimens, in the Spanish CoRIS cohort.</p> </sec> <sec id="hiv12104-sec-0002" sec-type="section"> <title>Methods</title> <p>CoRIS is a contemporary, multicentre cohort of HIV‐infected patients, antiretroviral‐naïve at entry, launched in 2004. Poisson regression models were used to investigate demographic, clinical and treatment‐related factors associated with a higher incidence of clinically significant depression to October 2010.</p> </sec> <sec id="hiv12104-sec-0003" sec-type="section"> <title>Results</title> <p>In total, 5185 patients (13 089 person‐years) participated in the study, of whom 3379 (65.2%) started ART during follow‐up. The incidence rates of depression before and after starting ART were 11.68 [95% confidence interval (CI) 9.01–15.15] and 7.06 (95% CI 5.45–9.13) cases per 1000 person‐years, respectively. After adjustment, there was an inverse association between the occurrence of depression and the initiation of ART [incidence rate ratio (IRR) 0.53; 95% CI 0.28–0.99], while the likelihood of depression increased in patients of age > 50 years (IRR 1.94; 95% CI 1.21–3.12). Longer exposure to ART was associated with a decreased IRR of depression in unadjusted and adjusted analyses. The IRR for patients receiving < 2, 2–4 and > 4 years of ART was 0.72 (95% CI 0.36–1.44), 0.10 (95% CI 0.04–0.25) and 0.05 (95% CI 0.01–0.17), respectively, compared with ART‐naïve patients. This protective effect was also observed when durations of exposure to nonnucleoside reverse transcriptase inhibitor‐based regimens and efavirenz‐containing regimens were analysed separately.</p> </sec> <sec id="hiv12104-sec-0004" sec-type="section"> <title>Conclusions</title> <p>The incidence of clinically significant depression was lower among HIV‐infected patients on ART. The protective effect of ART was also observed with efavirenz‐containing regimens.</p> </sec> </abstract>