Patient Preference, Sleep Quality, and Anxiety/Depression: A Comparison of Raltegravir and Efavirenz

University Hospital, Geneva60 enrolled

Overview

Efavirenz causes neuropsychiatric side effects and sleep disturbance, including vivid dreams, dizziness, and abnormal tiredness. These symptoms are frequent during the first weeks of treatment, with subsequent attenuation but may not completely resolve even years after efavirenz initiation. The investigators plan a four week, randomized, placebo-controlled, double-blind study. In group 1, efavirenz will be replaced with efavirenz placebo plus raltegravir, in group 2, efavirenz would be continued, and raltegravir placebo given in addition. After two weeks, patients in group 1 would switch to the regimen of group 2, and vice versa. The primary endpoint of the trial will be patient preference. Sleep quality, daytime sleepiness, and anxiety will also be investigated.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Sleep Disorders HIV Infections

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients \> 18 years * Signing the study consent form and agree to change ART regimen * Stable HAART including EFV since at least 3 months * HIV-RNA below 50 copies for at least 3 months Exclusion Criteria: * No major psychiatric disease (psychosis, severe depression) diagnosed before the initiation of EFV * Mentally incompetent patients * Pregnancy or lactation Women of childbearing potential must use one or two reliable contraceptive methods during the trial, from day 1 to the end of week 12. Acceptable methods include the birth control pill, IUD, condoms with spermicides. Non-acceptable methods include (non-exhaustive list): Withdrawal, calendar (Onigo method), or spermicides alone. * Concomitant renal or hepatic disease: * Creatinine above 150 micromol/L * Transaminases above 5 times upper normal limit * Prothrombin (Quick) value below 50%

Outcomes

Primary Outcomes

Symptoms and neurological side effects of study drugs

Time frame: baseline, week 2 and week 4

Secondary Outcomes

Levels of daytime sleepiness

Time frame: baseline, week 2 and week 4

Sleep Quality

Time frame: baseline, week 2 and week 4

Patient preference

Time frame: 4 weeks

Symptoms of depression, anxiety and stress will be assessed

Time frame: baseline, week 2 and week 4

Patient Preference, Sleep Quality, and Anxiety/Depression: A Comparison of Raltegravir and Efavirenz

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts