Long-term safety and efficacy of NNRTI within the central nervous system.
OBJECTIVE
To find out about the long-term safety and efficacy of nonnucleoside reverse transcriptase inhibitors (NNRTIs) within the central nervous system (CNS) in the context of reports suggesting a higher incidence of severe neuropsychiatric disorders resulting from HIV treatment with efavirenz (EFV).


METHODS
Retrospective analysis of a large cohort with regular neuropsychiatric follow-up. We compared 414 patients on EFV and 320 on nevirapine (NVP) with regard to CD4 cell count, HIV plasma viral burden, CNS dysfunction described by psychomotor speed, HIV dementia scale, neuropsychological tests assessing memory and attention, self-reported psychiatric and somatic complaints, depression, and psychosis.


RESULTS
No significant differences between both types of NNRTI treatment regimens were found with regard to duration of therapy and reasons for withdrawal: virological failure, neurological failure, and neuropsychiatric side effects including the manifestation of depression, psychosis, insomnia, or other self-reported complaints.


CONCLUSIONS
The present data do not provide evidence for a higher incidence of light and/or severe neuropsychiatric side effects associated with NNRTI treatment.
von Giesen
Hans Jürgen
HJ
Department of Neurology, Heinrich Heine University Düsseldorf, Germany. giesenhj@uni-duesseldorf.de
Köller
Hubertus
H
de Nocker
Dominique
D
Haslinger
Bernhard A
BA
Arendt
Gabriele
G
D000328:Adult; D000480:Alkynes; D048588:Benzoxazines; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003521:Cyclopropanes; D005260:Female; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D008297:Male; D001523:Mental Disorders / Q000139:chemically induced / Q000453:epidemiology* / Q000209:etiology; D019829:Nevirapine / Q000008:administration & dosage / Q000009:adverse effects*; D010078:Oxazines / Q000008:administration & dosage / Q000009:adverse effects*; D015995:Prevalence; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D019562:Viral Load
D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D010078:Oxazines; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine; C098320:efavirenz