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Observational Study
. 2022 May 11;14(5):1028.
doi: 10.3390/v14051028.

Reversibility of Central Nervous System Adverse Events in Course of Art

Lucia Taramasso  1 , Giancarlo Orofino  2 , Elena Ricci  3 , Barbara Menzaghi  4 , Giuseppe Vittorio De Socio  5 , Nicola Squillace  6 , Giordano Madeddu  7 , Francesca Vichi  8 , Benedetto Maurizio Celesia  9 , Chiara Molteni  10 , Federico Conti  11 , Filippo Del Puente  12 , Eleonora Sarchi  13 , Goffredo Angioni  14 , Antonio Cascio  15 , Carmela Grosso  16 , Giustino Parruti  17 , Antonio Di Biagio  12 , Paolo Bonfanti  6 ; CISAI Study Group
Affiliations
Observational Study

Reversibility of Central Nervous System Adverse Events in Course of Art

Lucia Taramasso et al. Viruses. .

Abstract

The purpose of this study is to evaluate the frequency of central nervous system adverse events (CNS-AE) on dolutegravir (DTG) and non-DTG containing ART, and their reversibility, in the observational prospective SCOLTA cohort. Factors associated with CNS-AE were estimated using a Cox proportional-hazards model. 4939 people living with HIV (PLWH) were enrolled in DTG (n = 1179) and non-DTG (n = 3760) cohorts. Sixty-six SNC-AE leading to ART discontinuation were reported, 39/1179 (3.3%) in DTG and 27/3760 (0.7%) in non-DTG cohort. PLWH naïve to ART, with higher CD4 + T count and with psychiatric disorders were more likely to develop a CNS-AE. The risk was lower in non-DTG than DTG-cohort (aHR 0.33, 95% CI 0.19−0.55, p < 0.0001). One-year follow-up was available for 63/66 PLWH with CNS-AE. AE resolution was reported in 35/39 and 23/24 cases in DTG and non-DTG cohorts, respectively. The probability of AE reversibility was not different based on ART class, sex, ethnicity, CDC stage, or baseline psychiatric disorder. At the same time, a lower rate of event resolution was found in PLWH older than 50 years (p = 0.017). In conclusion, CNS-AE leading to ART discontinuation was more frequent in DTG than non-DTG treated PLWH. Most CNS-AE resolved after ART switch, similarly in both DTG and non-DTG cohorts.

Keywords: CNS; HIV; adverse events; dolutegravir; neurocognitive; psychiatric; reversibility.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Survival analysis in strata of DTG and non-DTG-based regimens showed a significantly higher rate of discontinuations due to CNS-AE in DTG (logrank p < 0.0001).
See this image and copyright information in PMC

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