Reversibility of Central Nervous System Adverse Events in Course of Art.
Lucia TaramassoGiancarlo OrofinoElena Delfina RicciBarbara MenzaghiGiuseppe Vittorio De SocioNicola SquillaceGiordano MadedduFrancesca VichiBenedetto Maurizio CelesiaChiara MolteniFederico ContiFilippo Del PuenteEleonora SarchiGoffredo AngioniAntonio CascioCarmela GrossoGiustino ParrutiAntonio Di BiagioBonfanti Paolonull nullPublished in: Viruses (2022)
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.