Sleep Profile and Self-Reported Neuropsychiatric Symptoms in Vertically HIV-Infected Adolescents on cART

Maria Isabel González-Tomé; Cristina García-Navarro; Beatriz Ruiz-Saez; Talía Sainz; Santiago Jiménez de Ory; Pablo Rojo; María José Mellado Peña; Luis Prieto; Maria Angeles Muñoz-Fernandez; Berta Zamora; Isabel Cuéllar-Flores; Carlos Velo; Manuela Martin-Bejarano; José Tomás Ramos; María Luisa Navarro Gómez

doi:10.1055/s-0038-1673416

Journal of Pediatric Infectious Diseases, Table of Contents

J Pediatr Infect Dis 2018; 13(04): 300-307
DOI: 10.1055/s-0038-1673416

Original Article

Georg Thieme Verlag KG Stuttgart · New York

Sleep Profile and Self-Reported Neuropsychiatric Symptoms in Vertically HIV-Infected Adolescents on cART

Maria Isabel González-Tomé

¹Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain

,

Cristina García-Navarro

¹Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain

,

Beatriz Ruiz-Saez

²Molecular Biology and Immunology Laboratory, HIV Spanish Biobank, Hospital Universitario Gregorio Marañón, Madrid, Spain

,

Talía Sainz

³Department of Paediatric Infectious Diseases, Hospital La Paz Institute for Health Research (IDIPAZ), Hospital Universitario La Paz, Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain

,

Santiago Jiménez de Ory

²Molecular Biology and Immunology Laboratory, HIV Spanish Biobank, Hospital Universitario Gregorio Marañón, Madrid, Spain

,

Pablo Rojo

¹Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain

,

María José Mellado Peña

³Department of Paediatric Infectious Diseases, Hospital La Paz Institute for Health Research (IDIPAZ), Hospital Universitario La Paz, Translational Research Network in Pediatric Infectious Diseases (RITIP), Madrid, Spain

,

Luis Prieto

¹Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain

,

Maria Angeles Muñoz-Fernandez

²Molecular Biology and Immunology Laboratory, HIV Spanish Biobank, Hospital Universitario Gregorio Marañón, Madrid, Spain

,

Berta Zamora

⁴Department of Neuropsychology, Hospital Universitario 12 de Octubre, Madrid, Spain

,

Isabel Cuéllar-Flores

⁵Department of Psychology/Paediatric, Hospital Universitario Clínico San Carlos, Madrid, Spain

,

Carlos Velo

¹Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain

,

Manuela Martin-Bejarano

¹Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain

,

José Tomás Ramos

⁶Department of Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain

,

María Luisa Navarro Gómez

⁷Department of Paediatric Infectious Diseases, Hospital Universitario Gregorio Marañón, Madrid, Spain

› Author Affiliations

Abstract

Background Sleep quality (SQ) data in human immunodeficiency virus (HIV) pediatric population are scarce. Our main objective was to assess SQ in our cohort and to determine the impact of antiretroviral therapy (ART) on sleep in a cohort of HIV-infected adolescents on cART.

Materials and Methods The SQ was assessed through the Pittsburgh Sleep Quality Index (PSQI). Neuropsychiatric symptoms (NS) were recorded using an auto-administered questionnaire. To determine the antiretroviral (ARV) impact of efavirenz (EFV) on SQ, patients on EFV versus protease inhibitors-based regimens were compared.

Results Forty-six patients were evaluated (median age: 16 years, interquartile range [IQR]: 10.8, 17)). Age at the start of ART: 1.3 years (0.4, 5.2); 23.9% showed acquired immunodeficiency syndrome (AIDS) category. Median CD4 at baseline was 656 (550, 808) cells/mm³; 91.3% had viral load <50 copies/mL. Median time on cART was 11.3 years (7.5, 15.2). Fifty-two percent of the patients were on EFV-based regimen. No differences were found in clinical and immunovirological variables although patients on EFV were older and were exposed for a longer time to ARV. Poor SQ was found in 26.1% of patients. Most frequent complaints were: sleep disturbances (76.1%), sleep latency (63%), and daytime dysfunction (54.3%). Similarly, there were no significant differences in NS between both treatment groups according to patients' reports but were significantly more common in bad sleepers. Patients on EFV-based regimen were more likely to repeat one or more school grades after the adjustment for age at evaluation and nadir CD4 percentage (odds ratio [OR]: 14.421, confidence interval [CI] 95%: 1.207–172.249, p = 0.035).

Conclusions Sleep complaints and NS are common among our cohort of HIV adolescents on long-term cART and interestingly, not only in those who were receiving EFV.

Keywords

perinatal HIV infection - adolescents - sleep quality - antiretrovirals - neuropsychiatric symptoms

Full Text

References

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