Talks
Presenting Author Academic/Professional Position
Medical Student
Academic Level (Author 1)
Medical Student
Academic Level (Author 2)
Faculty
Presentation Type
Oral Presentation
Discipline Track
Clinical Science
Abstract Type
Research/Clinical
Abstract
Background: Integrase strand transfer inhibitors (InSTIs) are first-line therapy in the U.S. and other countries. One InSTI drug, dolutegravir (DTG), has been linked to neuropsychiatric adverse events but few reports have used standardized assessments of depression or assessed the concomitant influence of age and antidepressant use. These analyses aimed to determine the relationships between InSTI use, aging, antidepressant use, and depressive symptoms in people with HIV (PWH).
Methods: All 280 participants were comprehensively assessed in the CHARTER Aging project; were taking cART; and had plasma HIV RNA ≤ 200 copies/mL. The project enrolled participants based on chronological age < or ≥ 60 years. The Beck Depression Inventory (BDI)-II and four subscales were compared to demographic characteristics, use of InSTIs and antidepressants, and clinical biomarkers in a cross-sectional design by multivariable linear regression, including backward selection by Akaike Information Criterion.
Results: Participant characteristics included a median age of 56 years (28.7% > 60), 18.3% female, 38.8% black, 71.7% AIDS, the median duration of the current ART regimen of 19.4 months, and 67.8% InSTI use. Overall, InSTI use was not associated with BDI-II but DTG use trended toward association with worse BDI-II scores (p=0.064). Multivariable analysis identified that non-black race (p=0.0033), DTG use (p=0.0042), female sex (p=0.011), antidepressant use (p=0.039), and age ≥ 60 (p=0.056) were associated with worse BDI-II scores. The effects of DTG were present in the Apathy (p=0.0027), Cognitive (p=0.019), and Somatic (p=0.020) BDI-II subscales. Interaction analyses identified that DTG was associated with worse BDI-II principally among those older than 60 years (interaction p=0.026).
Conclusions: DTG may increase depressive symptoms in older PWH and those who use an antidepressant. Additionally, DTG worsened depressive symptoms in non-Black individuals. Others have reported neuropsychiatric adverse events associated with DTG, but this is the first study to use a standardized depression assessment and to identify an interaction with antidepressants, which may provide mechanistic and clinical insights to improve the care of PWH.
Recommended Citation
Bhatia, Sonya A.; Roy, Upal; Garg, Ankita; Kamkwalala, Asante R.; Matthews, Avery; Clifford, David B.; Gelman, Benjamin; Morgell, Susan; Patel, Payal; Rubin, Leah H.; Franklim, Donald; Heaton, Robert K.; Ellis, Ronald J.; and Letendre, Scott L., "The Long-term Effect of Dolutegravir on Depressive Side Effects: A CHARTER Cohort Study on People with HIV" (2025). Research Symposium. 29.
https://scholarworks.utrgv.edu/somrs/2025/talks/29
Included in
The Long-term Effect of Dolutegravir on Depressive Side Effects: A CHARTER Cohort Study on People with HIV
Background: Integrase strand transfer inhibitors (InSTIs) are first-line therapy in the U.S. and other countries. One InSTI drug, dolutegravir (DTG), has been linked to neuropsychiatric adverse events but few reports have used standardized assessments of depression or assessed the concomitant influence of age and antidepressant use. These analyses aimed to determine the relationships between InSTI use, aging, antidepressant use, and depressive symptoms in people with HIV (PWH).
Methods: All 280 participants were comprehensively assessed in the CHARTER Aging project; were taking cART; and had plasma HIV RNA ≤ 200 copies/mL. The project enrolled participants based on chronological age < or ≥ 60 years. The Beck Depression Inventory (BDI)-II and four subscales were compared to demographic characteristics, use of InSTIs and antidepressants, and clinical biomarkers in a cross-sectional design by multivariable linear regression, including backward selection by Akaike Information Criterion.
Results: Participant characteristics included a median age of 56 years (28.7% > 60), 18.3% female, 38.8% black, 71.7% AIDS, the median duration of the current ART regimen of 19.4 months, and 67.8% InSTI use. Overall, InSTI use was not associated with BDI-II but DTG use trended toward association with worse BDI-II scores (p=0.064). Multivariable analysis identified that non-black race (p=0.0033), DTG use (p=0.0042), female sex (p=0.011), antidepressant use (p=0.039), and age ≥ 60 (p=0.056) were associated with worse BDI-II scores. The effects of DTG were present in the Apathy (p=0.0027), Cognitive (p=0.019), and Somatic (p=0.020) BDI-II subscales. Interaction analyses identified that DTG was associated with worse BDI-II principally among those older than 60 years (interaction p=0.026).
Conclusions: DTG may increase depressive symptoms in older PWH and those who use an antidepressant. Additionally, DTG worsened depressive symptoms in non-Black individuals. Others have reported neuropsychiatric adverse events associated with DTG, but this is the first study to use a standardized depression assessment and to identify an interaction with antidepressants, which may provide mechanistic and clinical insights to improve the care of PWH.
