Efectos neuropsiquiátricos del efavirenz en pacientes con VIH-1: evidencia de un estudio retrospectivo en Colombia (2020–2024)
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Fecha
2025
Autores
Navarro Mercado, Lilian Paola
Orozco Cruz, Ingrid Yeraldin
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
El VIH/SIDA (Virus de la Inmunodeficiencia Humana/Síndrome de Inmunodeficiencia Adquirida) sigue siendo un grave problema de salud pública a nivel mundial, a pesar de los avances en el tratamiento antirretroviral, las campañas de concientización y los programas de prevención. Efavirenz, un inhibidor no nucleósido de la transcriptasa inversa, es comúnmente utilizado en los esquemas de tratamiento de primera línea. Frente a esto, la presente investigación buscó determinar la prevalencia de los síntomas neuropsiquiátricos en pacientes diagnosticados con VIH que han recibido terapia farmacológica con efavirenz. Se realizó un estudio observacional, transversal y retrospectivo, con base en la revisión de historias clínicas, que implicó un análisis descriptivo y el uso de los estadísticos de prueba χ² y Fisher (α=0,05). En cuanto a los resultados, los síntomas más frecuentes fueron las alteraciones en el patrón del sueño, depresión y cuadros mixtos ansiedad-depresión; los síntomas psicóticos se observaron solo en hombres. El sexo masculino se asoció con mayor presencia de síntomas (p=0,012). Se encontró una asociación significativa con CD4 >500 células/mm³ (p=0,0035) y cargas virales indetectables (p=0,0039), lo que sugiere un efecto relacionado con exposición continua y la buena adherencia. No se hallaron asociaciones importantes con escolaridad, estado civil, ocupación, comorbilidades, apoyo social, tiempo desde diagnóstico ni adherencia (p>0,05). También se observó que tras la suspensión de efavirenz, la mejoría fue rápida: 62,64% en 1 mes, 32,97% en 2 meses y 4,40% en 3 meses. A partir de esto se pudo concluir que el efavirenz se relaciona con una carga relevante de síntomas neuropsiquiátricos, especialmente del sueño y afectivos; dentro del perfil de riesgo se incluye ser hombre y presentar buen control inmunovirológico.
HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) remains a serious global public health problem despite advances in antiretroviral therapy, awareness campaigns, and prevention programs. Efavirenz, a non- nucleoside reverse transcriptase inhibitor, is commonly used in first-line treatment regimens. In this context, the present study aimed to determine the prevalence of neuropsychiatric symptoms in patients diagnosed with HIV who received pharmacological therapy with efavirenz. An observational, cross-sectional, and retrospective study was conducted based on the review of medical records, which involved descriptive analysis and the use of χ² and Fisher’s exact tests (α=0.05). Regarding the results, the most frequent symptoms were sleep pattern disturbances, depression, and mixed anxiety–depression syndromes; psychotic symptoms were observed only in men. Male sex was significantly associated with a higher presence of symptoms (p=0.012). A significant association was also found with CD4 >500 cells/mm³ (p=0.0035) and undetectable viral loads (p=0.0039), suggesting an effect related to continuous exposure and good adherence. No significant associations were found with educational level, marital status, occupation, comorbidities, social support, time since diagnosis, or adherence (p>0.05). After discontinuing efavirenz, rapid improvement was observed: 62.64% in 1 month, 32.97% in 2 months, and 4.40% in 3 months. It was concluded that efavirenz is associated with a considerable burden of neuropsychiatric symptoms, especially sleep and affective disturbances; the risk profile includes being male and presenting good immunovirological control.
HIV/AIDS (Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome) remains a serious global public health problem despite advances in antiretroviral therapy, awareness campaigns, and prevention programs. Efavirenz, a non- nucleoside reverse transcriptase inhibitor, is commonly used in first-line treatment regimens. In this context, the present study aimed to determine the prevalence of neuropsychiatric symptoms in patients diagnosed with HIV who received pharmacological therapy with efavirenz. An observational, cross-sectional, and retrospective study was conducted based on the review of medical records, which involved descriptive analysis and the use of χ² and Fisher’s exact tests (α=0.05). Regarding the results, the most frequent symptoms were sleep pattern disturbances, depression, and mixed anxiety–depression syndromes; psychotic symptoms were observed only in men. Male sex was significantly associated with a higher presence of symptoms (p=0.012). A significant association was also found with CD4 >500 cells/mm³ (p=0.0035) and undetectable viral loads (p=0.0039), suggesting an effect related to continuous exposure and good adherence. No significant associations were found with educational level, marital status, occupation, comorbidities, social support, time since diagnosis, or adherence (p>0.05). After discontinuing efavirenz, rapid improvement was observed: 62.64% in 1 month, 32.97% in 2 months, and 4.40% in 3 months. It was concluded that efavirenz is associated with a considerable burden of neuropsychiatric symptoms, especially sleep and affective disturbances; the risk profile includes being male and presenting good immunovirological control.
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Efavirenz, Salud Mental, Depresión, VIH-1, Trastornos del sueño, Síntomas neuropsiquiátricos