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Parra-Rodriguez L, O'Halloran J, Wang Y, Jin W, Dastgheyb RM, Spence AB, Sharma A, Gustafson DR, Milam J, Weber KM, Adimora AA, Ofotokun I, Fischl MA, Konkle-Parker D, Maki PM, Xu Y, Rubin LH. Common antiretroviral combinations are associated with somatic depressive symptoms in women with HIV. AIDS 2024; 38:167-176. [PMID: 37773048 DOI: 10.1097/qad.0000000000003730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
OBJECTIVE While modern antiretroviral therapy (ART) is highly effective and safe, depressive symptoms have been associated with certain ART drugs. We examined the association between common ART regimens and depressive symptoms in women with HIV (WWH) with a focus on somatic vs. nonsomatic symptoms. DESIGN Analysis of longitudinal data from the Women's Interagency HIV Study. METHODS Participants were classified into three groups based on the frequency of positive depression screening (CES-D ≥16): chronic depression (≥50% of visits since study enrollment), infrequent depression (<50% of visits), and never depressed (no visits). Novel Bayesian machine learning methods building upon a subset-tree kernel approach were developed to estimate the combined effects of ART regimens on depressive symptoms in each group after covariate adjustment. RESULTS The analysis included 1538 WWH who participated in 12 924 (mean = 8.4) visits. The mean age was 49.9 years, 72% were Black, and 14% Hispanic. In the chronic depression group, combinations including tenofovir alafenamide and cobicistat-boosted elvitegravir and/or darunavir were associated with greater somatic symptoms of depression, whereas those combinations containing tenofovir disoproxil fumarate and efavirenz or rilpivirine were associated with less somatic depressive symptoms. ART was not associated with somatic symptoms in the infrequent depression or never depressed groups. ART regimens were not associated with nonsomatic symptoms in any group. CONCLUSIONS Specific ART combinations are associated with somatic depressive symptoms in WWH with chronic depression. Future studies should consider specific depressive symptoms domains as well as complete drug combinations when assessing the relationship between ART and depression.
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Affiliation(s)
- Luis Parra-Rodriguez
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Jane O'Halloran
- Department of Medicine, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Yuezhe Wang
- Department of Applied Mathematics and Statistics, Johns Hopkins University
| | - Wei Jin
- Department of Applied Mathematics and Statistics, Johns Hopkins University
| | - Raha M Dastgheyb
- Departments of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Amanda B Spence
- Department of Medicine, Division of Infectious Disease and Tropical Medicine, Georgetown University, Washington, DC
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx
| | - Deborah R Gustafson
- Department of Neurology, State University of New York Downstate Health Sciences University, Brooklyn, New York
| | - Joel Milam
- Department of Epidemiology and Biostatistics, University of California, Irvine, California
| | - Kathleen M Weber
- Cook County Health and Hektoen Institute of Medicine, Chicago, Illinois
| | - Adaora A Adimora
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Igho Ofotokun
- Department of Medicine, Division of Infectious Diseases, Emory University, Atlanta, Georgia
| | - Margaret A Fischl
- Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, Florida
| | - Deborah Konkle-Parker
- Schools of Nursing, Medicine and Population Health, University of Mississippi Medical Center, Jackson, Mississippi, Mississippi
| | - Pauline M Maki
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Yanxun Xu
- Department of Applied Mathematics and Statistics, Johns Hopkins University
- Division of Biostatistics and Bioinformatics at The Sidney Kimmel Comprehensive Cancer Center
| | - Leah H Rubin
- Departments of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Psychiatry and Behavioral Sciences
- Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Taramasso L, Lo Caputo S, Magnasco L, Briano F, Poliseno M, Bruno SR, Ferrara S, Pincino R, Sarteschi G, Beltramini S, Sasso E, Mora S, Giacomini M, Bassetti M, Di Biagio A. Long-Term Effectiveness of Rilpivirine-Based Single-Tablet Regimens in a Seven-Year, Two-Center Observational Cohort of People Living with HIV. AIDS Res Hum Retroviruses 2022; 38:472-479. [PMID: 35172617 DOI: 10.1089/aid.2021.0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Data on the long-term durability of rilpivirine (RPV) are still scarce. A two-center retrospective study was performed, including all people living with HIV (PLWH) treated with tenofovir disoproxil fumarate/emtricitabine (TDF/FTC)/RPV or tenofovir alafenamide (TAF)/FTC/RPV in the period January 2013-December 2019. Aims of the study were to assess the rate of discontinuation of the RPV single-tablet regimen (STR) and identify factors associated with the risk of discontinuation according to Cox's regression analysis. A total of 684 PLWH were enrolled. Mean duration of RPV-STR treatment was 192.5 (±99.5) weeks for 123 antiretroviral therapy (ART)-naïve participants (18%) and 173.3 (± 85.6) weeks for 561 ART-experienced study participants (82%). During the study period, the incidence of discontinuation was 7.7 per 100 person-years. The estimated proportions of discontinuation after 48 and 96 weeks were 5.6% and 13.4%, respectively. Causes of discontinuation were loss to follow-up (30%), side effects (15%), ART optimization (14%), virological failure (VF) (12%), death or transfer to another center (9%), low adherence (7%), drug interactions (6%), simplification to dual therapy (3%), and unknown (3%). No differences were observed in cumulative probability of discontinuation between ART-naïve and -experienced PLWH. Heterosexual (hazard ratio [HR] 3.0, 95% confidence interval [CI] 1.4-6.8) and mother-to-child (HR 5.3, 95% CI 1.8-15.3) transmission of HIV infection and history of previous VF (HR 1.7, 95% CI 1.2-2.5) were associated with higher risk of discontinuation. High RPV-STR effectiveness and durability were confirmed in our real-life population of PLWH. Given these data, RPV has the potential to be a drug for life in patients selected according to current guidelines.
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Affiliation(s)
- Lucia Taramasso
- Infectious Diseases Clinic, Department of Internal Medicine, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Sergio Lo Caputo
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Laura Magnasco
- Infectious Diseases Clinic, Department of Internal Medicine, IRCCS Policlinico San Martino Hospital, Genoa, Italy
| | - Federica Briano
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, San Martino Hospital-IRCCS, Genoa, Italy
| | - Mariacristina Poliseno
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Serena Rita Bruno
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Sergio Ferrara
- Unit of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Rachele Pincino
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, San Martino Hospital-IRCCS, Genoa, Italy
| | - Giovanni Sarteschi
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, San Martino Hospital-IRCCS, Genoa, Italy
| | | | - Elisabetta Sasso
- Pharmacy Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Sara Mora
- Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy
| | - Mauro Giacomini
- Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy
| | - Matteo Bassetti
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, San Martino Hospital-IRCCS, Genoa, Italy
| | - Antonio Di Biagio
- Infectious Diseases Clinic, Department of Health Sciences, University of Genoa, San Martino Hospital-IRCCS, Genoa, Italy
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Potard V, Gallien S, Canestri A, Costagliola D. Use of rilpivirine in HIV-1-infected individuals in routine clinical practice from 2012 to 2017 in France. J Antimicrob Chemother 2021; 76:467-476. [PMID: 33257955 DOI: 10.1093/jac/dkaa449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/29/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES We assessed virological outcomes of rilpivirine use in France from 2012 to 2017, in three groups of people living with HIV (PLHIV): (i) antiretroviral (ARV)-naive PLHIV; (ii) ARV-experienced PLHIV switching to rilpivirine while failing therapy; and (iii) ARV-experienced PLHIV switching to rilpivirine while virologically controlled. METHODS Virological success (VS) was defined as a plasma HIV-1 viral load (VL) <50 copies/mL and virological failure (VF) as two consecutive VL >50 copies/mL or one VL >50 copies/mL followed by a treatment switch prior to the next VL measurement. The cumulative incidence of VS was assessed considering rilpivirine discontinuation, loss to follow-up and death as competing risks, while estimates of cumulative incidence of VF accounted for loss to follow-up and death. RESULTS Among the 2166 ARV-naive PLHIV initiating rilpivirine, the 4 year cumulative incidence of VS was 91.0% and was associated with baseline VL. Among the 2125 ARV-experienced PLHIV switching to rilpivirine while failing therapy, the 4 year cumulative incidence of VS was 82.5% and was associated with lower VL, higher CD4 and less than three prior ARVs. Among the 11 828 ARV-experienced PLHIV switching to rilpivirine while virologically controlled, the 4 year cumulative incidence of VF was 9.6%. The risk of VF was lower among MSM, for PLHIV with CD4 ≥ 500 cell/mm3, without a prior AIDS event, or with a longer VL suppression at baseline. CONCLUSIONS Rilpivirine-containing regimens yielded high rates of viral suppression in most participants, while it was ineffective when used outside the marketing authorization in naive participants.
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Affiliation(s)
- Valérie Potard
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
| | - Sebastien Gallien
- AP-HP, Hôpital Henri Mondor, Service d'Immunologie et Maladies Infectieuses, Université Paris Est Créteil, Inserm U 955, Créteil, France
| | - Ana Canestri
- AP-HP, Hôpital de Tenon, Service des Maladies Infectieuses et Tropicales, Paris, France
| | - Dominique Costagliola
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique (IPLESP), Paris, France
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