Neuropsychiatric Side Effects Associated with Efavirenz Therapy in HIV/AIDS Patients

Introduction: Efavirenz is a potent, safe and tolerable non-nucleoside reverse transcriptase inhibitor recommended as one component of the initial combination therapy in HIV/AIDS patients. The most frequent adverse effects with efavirenz are neuropsychiatric symptoms, which affect more than 50% of patients. Patients and Methods: We conducted a retrospective study on 89 naive HIV/AIDS patients followed by the infectious disease and clinical microbiology outpatient clinic between January 2006 and March 2009. Age, gender, CD4 cell counts, antiretroviral therapies and side effects were collected by retrospective analysis of follow-up records. Results: A total of 89 naive HIV/AIDS patients were analyzed. Sixty-seven (75%) patients were on HAART (highly active antiretroviral therapy), had CD4 cell count of < 350/mm3. Of 35 (39%) patients receiving efavirenz, 28 (80%) were men. The mean age was 37 (22-68) years. Neuropsychiatric adverse events were reported by 14 (40%) efavirenz cases. These symptoms resolved after the first four weeks; side effect did not results in cessation of the drug in any of the cases. Conclusion: Before initiating efavirenz therapy, all patients should be cautioned about the side effects of the drug to increase therapy adaptation, and they should be informed not to stop taking the drug without first consulting their physicians