Efavirenz use and neurocognitive performance among older people living with HIV who were on antiretroviral therapy

ABSTRACT

This study was to compare global and domain-specific neurocognitive performance between older people living with HIV (PLWH) taking/not taking efavirenz (EFV) and HIV-negative controls. A cross-sectional study was conducted in Yongzhou city, China. All PLWH older than 50 years listed on the registry of Centres for Disease Control and Prevention were invited to join the study. Frequency matching was used to sample HIV-negative controls according to the distribution of age, sex, and years of formal education of older PLWH. A total of 308 older PLWH and 350 HIV-negative controls completed the face-to-face interview and neurocognitive assessment using the comprehensive neuropsychological test battery. After adjusting for significant confounders, older PLWH taking EFV showed poorer performance in memory (p = 0.020), verbal fluency (p = 0.002), and poorer global neurocognitive performance (p = 0.032) than those without EFV use. Compared to HIV-negative controls, older PLWH taking EFV had poorer performance in all neurocognitive domains (p values: <0.001–0.003) and poorer global neurocognitive performance (p < 0.001). Similar trends were observed when comparing older PLWH without using EFV versus HIV-negative controls, with the exception of verbal fluency (p = 0.560). Health care workers should monitor the neuropsychological performance of older PLWH, epically those who were taking EFV. Longitudinal studies are warranted.

KEYWORDS:

• Neurocognitive performance
• older people living with HIV
• Efavirenz use
• China

Acknowledgements

We are grateful for the participation and cooperation of participants in the study. Thanks to Prof. Tatia M.C. Lee in University of Hong Kong to allow the access to Chinese version of Auditory Verbal Learning Test developed by her team. We thank staff in the local CDCs and hospitals for the recruitment of the participants and assistance in data collection. This study was supported by the Health and Family Planning Commission in the Hunan Province, China (C2016031). The funders had no role in the study design, data collection, analysis and interpretation, or manuscript preparation.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by Health and Family Planning Commission in the Hunan Province, China [grant number C2016031].