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. 2020 May;72(5):719-727.
doi: 10.1111/jphp.13237. Epub 2020 Feb 11.

Increased risk of dizziness in human immunodeficiency virus-infected patients taking zidovudine and efavirenz combination: a Brazilian cohort study

Josué Jeyzon de Lima Soares Valeriano  1   2 , Wlisses Henrique Veloso Carvalho-Silva  2 , Antônio Victor Campos Coelho  2 , Ronald Rodrigues Moura  2 , Luiz Cláudio Arraes  2   3 , Lucas André Cavalcanti Brandão  2   4 , Sergio Crovella  1   5 , Rafael Lima Guimarães  1   2
Affiliations

Increased risk of dizziness in human immunodeficiency virus-infected patients taking zidovudine and efavirenz combination: a Brazilian cohort study

Josué Jeyzon de Lima Soares Valeriano et al. J Pharm Pharmacol. 2020 May.

Abstract

Objectives: Neuropsychiatric adverse effects (NPAE) related to efavirenz, mainly dizziness, is detrimental to human immunodeficiency virus (HIV) treatment. Our study aims at evaluating if zidovudine use potentiates the risk of dizziness related to efavirenz when used together and whether there are significant differences in over time distribution of this NPAE and others relatively frequents regarding efavirenz regimen without zidovudine.

Methods: Human immunodeficiency virus-infected patients under efavirenz-containing different therapy were enrolled. A retrospective analysis of official medical records was accomplished to collect clinical data regarding NPAE occurrence and severity. Univariate statistic and statistical model based on survival analyses were performed.

Key findings: One hundred sixty-two patients were included, of these seventy-seven (47.5%) had NPAE reported, such as dizziness (more frequent), depression and insomnia. Univariate statistical analysis demonstrated that the combined use of efavirenz with zidovudine increased the NPAE risk (OR: 2.5; P-value: 0.008), mainly dizziness risk (OR: 3.5; P-value: 0.009) and survival analysis showed that such combination is associated with dizziness occurrence faster (HR: 2.9; P-value: 0.02).

Conclusions: The results may contribute to clarify the dizziness occurrence dynamics in therapy with efavirenz and zidovudine by identifying susceptibilities and assisting in the choice of combined antiretroviral therapy.

Keywords: HIV-1; antiretroviral therapy; dizziness; neuropsychiatric adverse effects.

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References

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    1. Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas para Manejo da Infecção pelo HIV em Adultos. Ministério da Saúde-Secretaria de Vigilância em Saúde. Brasília, published in 2013, last modification in 2018.
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