title: Short Communication: The Impact of Switching from Atripla to Darunavir/Ritonavir Monotherapy on Neurocognition, Quality of Life, and Sleep: Results from a Randomized Controlled Study.
abstract: We investigated whether a treatment switch from Atripla®(tenofovir, emtricitabine, and efavirenz) to DRV/r monotherapy may improve neuropsychological performance, health-related quality of life, and sleep function. Virologically suppressed subjects and asymptomatic on Atripla for ≥6 months were randomized 1:1 to continue Atripla or switch to boosted darunavir (DRV/r) 800/100 mg once daily for 48 weeks. Neurocognitive tests, the International HIV Dementia Scale (IHDS), Medical Outcomes Study HIV Health Survey (MOS-HIV), EQ-5D-3L, and the Hospital Anxiety and Depression Scale (HADS) were completed at baseline and at week 48. Sleep function was evaluated at week 48. Twenty-six patients on DRV/r and 31 on Atripla completed the 48-week study. No significant difference in the change in scores from week 0 to week 48 between the two arms was observed in neurocognitive outcomes, IHDS, health outcomes (EQ-5D-3L and QOL), and HADS score. By contrast, the HADS score and sleep quality were both significantly better in the DRV/r arm. In conclusion, switching to DRV/r monotherapy did not affect neurocognitive function or quality of life but improved anxiety, and sleep quality was significantly better than in continued Atripla.
authors.affiliation: 1 Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Juan
authors.initials: J
authors.lastname: Tiraboschi
authors.affiliation: 2 Kings College Hospital NHS Foundation Trust , London, United Kingdom .
authors.forename: Lisa
authors.initials: L
authors.lastname: Hamzah
authors.affiliation: 1 Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Alastair
authors.initials: A
authors.lastname: Teague
authors.affiliation: 1 Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Ranjababu
authors.initials: R
authors.lastname: Kulasegaram
authors.affiliation: 2 Kings College Hospital NHS Foundation Trust , London, United Kingdom .
authors.forename: Frank
authors.initials: F
authors.lastname: Post
authors.affiliation: 1 Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jendruleck
authors.affiliation: 1 Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Tammy
authors.initials: T
authors.lastname: Murray
authors.affiliation: 1 Guy's and St. Thomas' NHS Foundation Trust , London, United Kingdom .
authors.forename: Julie
authors.initials: J
authors.lastname: Fox
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D000069454:Darunavir / Q000627:therapeutic use*; D057915:Drug Substitution; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D019438:Ritonavir / Q000627:therapeutic use*; D012890:Sleep / Q000187:drug effects*
chemical_list: D019380:Anti-HIV Agents; D000068257:Efavirenz, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination; D019438:Ritonavir; D000069454:Darunavir
keywords: anxiety; darunavir monotherapy; sleep