从 EFV/F/TDF 转为 B/F/TAF 对精神症状和神经认知的影响。

IF 3.4 2区 医学 Q3 IMMUNOLOGY
AIDS Pub Date : 2024-10-25 DOI:10.1097/QAD.0000000000004043
Alessandra Vergori, Giulia Del Duca, Patrizia Lorenzini, Anna Clelia Brita, Ilaria Mastrorosa, Marisa Fusto, Marta Camici, Sandrine Ottou, Roberta Gagliardini, Jessica Paulicelli, Federico De Zottis, Elisabetta Grilli, Rozenn Esvan, Maria Maddalena Plazzi, Valentina Mazzotta, Rita Bellagamba, Andrea Antinori, Carmela Pinnetti
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引用次数: 0

摘要

目的目的:研究从EFV/F/TDF转为B/F/TAF是否可以改善神经精神症状和神经认知:设计:对 HIV 感染者(PWH)进行单臂前瞻性试验研究,探讨从 EFV/F/TDF 转为 B/F/TAF 的疗效和安全性:方法: 参与者在换药时(T0)和 48 周后(T1)接受神经心理学评估(NPA)。神经心理评估由 12 项标准化测试组成。神经认知障碍(NCI)的定义是:至少在 2 项测试中得分比正常平均值低≥1 个标准差(SD),或在 1 项测试中得分比正常平均值低≥2 个标准差。确定单项 z 分值,NPZ-12 计算为 12 次测试 z 分值的平均值,NPZ-12 的变化即为结果。艾滋病毒相关神经认知障碍(HAND)根据弗拉斯卡蒂标准进行分类。采用贝克焦虑量表(BAI)、贝克抑郁量表(BDI-II)和匹兹堡睡眠质量指数(PSQI)。采用配对-威尔科克森检验和 McNemar 检验进行比较,并采用逻辑回归分析与 NCI 变化的关系:结果:在 126 名参与者中,BAI、BDI-II 和 PSQI 问卷显示在 T1 期有改善。NPA显示,40.5%的人在T0时出现NCI,42.1%的人在T1时出现NCI(p = 0.746)。具体而言,在 T0 期,有 NCI 的参与者中有 35% 的人病情有所改善;在 T1 期,没有 NCI 的参与者中有 26% 的人病情恶化;在 T1 期,NPZ-12 评分恶化。在 T0 时观察到 5.6% 的 ANI,在 T1 时观察到 7.9%。没有发现与这些变化相关的因素:我们的研究结果表明,从EFV/F/TDF改为B/F/TAF可显著改善精神症状和睡眠质量。神经认知表现保持稳定,但NPZ-12和特定领域的表现有所下降。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of switching from EFV/F/TDF to B/F/TAF on psychiatric symptoms and neurocognition.

Objectives: The aim was to investigate whether switching from EFV/F/TDF to B/F/TAF may improve neuropsychiatrc symptoms and neurocognition.

Design: Pilot, single-arm, prospective study of persons with HIV (PWH) on the efficacy and safety of switching from EFV/F/TDF to B/F/TAF.

Methods: Participants underwent neuropsychological assessment (NPA) at switch (T0) and after 48 weeks (T1). NPA was carried out through a standardized battery of 12 tests. Neurocognitive impairment (NCI) was defined by a score ≥1 standard deviation (SD) below the normal mean on at least 2 tests or ≥2 SD below on 1 test. Individual z-scores were determined, NPZ-12 was calculated as the average of 12 test z-scores and change of NPZ-12 was the outcome. HIV-associated Neurocognitive Disorder (HAND) was classified by Frascati's criteria. Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), and Pittsburgh Sleep Quality Index (PSQI) were administered. Paired-Wilcoxon and McNemar tests were used for comparisons, and logistic regression for associations with NCI changes.

Results: Out of 126 participants, BAI, BDI-II, and PSQI questionnaires revealed an improvement at T1. NPA revealed NCI in 40.5% of persons at T0 and 42.1% at T1 (p = 0.746). Specifically, at T0, among participants with NCI, 35% improved; among those without, 26% worsened at T1; NPZ-12 score worsened at T1. 5.6% of ANI was observed at T0 and 7.9% at T1. No factor associated with these changes was found.

Conclusions: Our results suggest switching from EFV/F/TDF to B/F/TAF significantly improves psychiatric symptoms and sleep quality. Neurocognitive performance remained stable, although a decline in NPZ-12 and in specific domains was observed.

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来源期刊
AIDS
AIDS 医学-病毒学
CiteScore
5.90
自引率
5.30%
发文量
478
审稿时长
3 months
期刊介绍: ​​​​​​​​​​​​​​​​​Publishing the very latest ground breaking research on HIV and AIDS. Read by all the top clinicians and researchers, AIDS has the highest impact of all AIDS-related journals. With 18 issues per year, AIDS guarantees the authoritative presentation of significant advances. The Editors, themselves noted international experts who know the demands of your work, are committed to making AIDS the most distinguished and innovative journal in the field. Submitted articles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.
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