HIV Drug May Increase Suicide Risk
the MPR take:
An antiretroviral regimen containing efavirenz for initial treatment of HIV has been linked to a 2-fold increase risk of suicidality vs. an efavirenz-free regimen. The study analyzed participant-level data from four AIDS clinical trial groups of antiretroviral-naive patients randomly assigned to an efavirenz-containing (n=3,241) or efavirenz-free (n= 2,091) regimen from 2001–2010. Suicidality incidence (defined as suicidal ideation, attempted suicide, or completed suicide) was 8.08 per 100 person-years in the efavirenz group vs. 3.66 in the efavirenz-free group (hazard ratio, 2.28 [95% CI, 1.27–4.10]; P=0.006). Rates of attempted or completed suicide were 2.90 and 1.22 in the efavirenz and efavirenz-free groups, respectively (hazard ratio, 2.58 [CI, 0.94–7.06]; P=0.065). Eight suicides in the efavirenz group and 1 in the efavirenz-free group were reported. Physicians should be aware of this increased risk in suicidality when prescribing a treatment regimen to antiretroviral-naive patients.
Background: The relationship between efavirenz use and suicidality is not well-defined. Objective:To compare time to suicidality with efavirenz-containing versus efavirenz-free antiretroviral regimens for initial treatment of HIV. Design: Participant-level data were analyzed from 4 AIDS Clinical Trials Group, antiretroviral-naive studies conducted from 2001–2010.
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