Neuropsychiatric symptoms in Tanzanian HIV-infected children receiving long-term efavirenz treatment: a multicentre, cross-sectional, observational study

This study is registered with ClinicalTrials.gov, number NCT03227653.FindingsBetween June 19, 2017, and Dec 14, 2017, 141 children were analysed, of whom 72 (51%) used efavirenz-based cART and 69 (49%) used non-efavirenz-based cART. After controlling for age, sex, and clinical and demographic confounders, we observed lower competence (adjusted mean difference −2·43 [95% CI −4·19 to −0·67], p=0·0071), largely driven by lower school performance scores (adjusted mean difference −0·91 [–1·42 to −0·40], p=0·00055), in the efavirenz group than in the non-efavirenz group. More total (adjusted mean difference 5·96 [95% CI −1·12 to 13·04], p=0·098) and internalising (adjusted mean difference 2·00 [–0·29 to 4·29], p=0·086) behavioural problems were seen in the efavirenz group than in the non-efavirenz group, although these findings were non-significant. No differences were found in externalising problems (adjusted mean difference 0·78 [95% CI −1·55 to 3·11], p=0·51).InterpretationOur results suggest that treatment with efavirenz in children is associated with a mild increase in neuropsychiatric symptoms, especially in children who receive doses higher than or equal to the WHO recommended doses for efavirenz. Clinical awareness and adequate follow-up of neuropsychiatric symptoms in efavirenz in children remain warranted.FundingAidsfonds, Radboud University Medical Center.
Source: The Lancet HIV - Category: Infectious Diseases Source Type: research