Pittsburgh Sleep Quality Index (PSQI) Changes in Virologically Suppressed People Living with HIVSwitching to Long-Acting Cabotegravir and Rilpivirine

Abstract

Background: Limited evidence is available about sleep quality changes associated with the use of Cabotegravir (CAB), a new, long-acting (LA) antiretroviral (ARV) drug belonging to the class of Integrase Strand Transfer Inhibitors (INSTIs).

Methods: Pittsburgh Sleep Quality Index (PSQI) was calculated in 53 people living with HIV (PLWH) under the care of the outpatient services of two Italian Infectious Diseases Centers in Apuliabefore (M0) and seven months after (M7) the switch to LA CAB. Global scores and relative subitems were compared using paired sample tests. The same analysis was repeated in subgroups of PLWH switching from INSTIs-, Dolutegravir-(DTG), and Bictegravir (BIC)-based regimens.

Results: A significant reduction was reported in global mean (±StandardDeviation, SD) PSQI at M7 compared to M0 (4 (±3) vs. 3 (±2), p = 0.01), particularly in the areas of sleep latency and sleep disturbances. The improvement was also significant in PLWH already on INSTIs- (from median 3 to 2 points, p = 0.02) and DTG-based (from median 4 to 2, p = 0.01) ARV regimens, but not among those who switched from BIC-based regimens.

Conclusions: PLWH reported improved sleep quality after switching from ARV treatment to LA CAB. Further studies are needed to give deeper insights into this phenomenon.

Keywords: HIV; PSQI; antiretroviral treatment; cabotegravir; sleep quality.

Figure 1

Results of PSQI collected at baseline (M0)) in PLWH switching to CAB + RPV LA from INSTIs- (a) and DTG-based ARV regimens (b). The analysis was repeated at Month 7 (M7) both in PLWH previously on INSTIs- (c) and DTG-based ARV regimens (d).

Figure 2

Results of PSQI were collected from 53 PLWH before (M0) and 7 months (M7) after the switch to CAB + RPV LA. Both differences in total score (a) and subscores of Item 1 to 7 (b–h) were outlined.