Abstract：
Second-generation integrase strand transfer inhibitors such as bictegravir (BIC) and dolutegravir (DTG) are the standard of care for starting therapy in people living with HIV (PLHIV). However, their use has been associated with neuropsychiatric symptoms (NPSs) that may lead to treatment discontinuation. We aim to describe and synthesize information on safety and discontinuation rates and to summarize potential risk factors associated with the development of NPSs in PLHIV treated with these regimens.
A systematic review of the literature was carried out in the international databases PubMed/Medline, Web of Science (WoS), Scopus, Embase, and Cochrane Library from 2013 to June 2022. Ninety observational studies reporting data on treatment discontinuation due to drug-related adverse events and NPSs were identified.
Discontinuation rates due to NPSs increase with treatment time and, in light of the reviewed studies, are higher in PLHIV treated with DTG-based regimens compared with those treated with BIC/emtricitabine/tenofovir alafenamide fumarate (BIC/FTC/TAF). This information could be useful for clinicians during treatment decision-making, reducing discontinuation rates and thereby promoting treatment success and durability. Additionally, the identification of potential risk factors in PLHIV prior to starting therapy could also help make the best therapy choices based on the characteristics of each individual.
A systematic review of the literature was carried out in the international databases PubMed/Medline, Web of Science (WoS), Scopus, Embase, and Cochrane Library from 2013 to June 2022. Ninety observational studies reporting data on treatment discontinuation due to drug-related adverse events and NPSs were identified.
Discontinuation rates due to NPSs increase with treatment time and, in light of the reviewed studies, are higher in PLHIV treated with DTG-based regimens compared with those treated with BIC/emtricitabine/tenofovir alafenamide fumarate (BIC/FTC/TAF). This information could be useful for clinicians during treatment decision-making, reducing discontinuation rates and thereby promoting treatment success and durability. Additionally, the identification of potential risk factors in PLHIV prior to starting therapy could also help make the best therapy choices based on the characteristics of each individual.
摘要：
■第二代整合酶链转移抑制剂，如比替格韦（BIC）和dolutegravir（DTG）是HIV感染者（PLHIV）开始治疗的标准护理。然而,它们的使用与可能导致治疗中断的神经精神症状(NPSs)相关.我们旨在描述和综合有关安全性和停药率的信息，并总结与这些方案治疗的PLHIV中NPS发展相关的潜在风险因素。
■在PubMed/Medline国际数据库中对文献进行了系统的回顾，WebofScience(WoS),Scopus,Embase,和Cochrane图书馆从2013年到2022年6月。确定了90项观察性研究，报告了由于药物相关不良事件和NPSs而终止治疗的数据。
■由于NPSs导致的停药率随着治疗时间的增加而增加，根据审查的研究，与使用BIC/恩曲他滨/富马酸替诺福韦艾拉酚胺（BIC/FTC/TAF）治疗的患者相比，使用基于DTG的方案治疗的PLHIV患者更高。这些信息可能对临床医生在治疗决策过程中有用，降低停药率，从而促进治疗的成功和耐久性。此外,在开始治疗前确定PLHIV的潜在危险因素也有助于根据每个个体的特征做出最佳治疗选择.
■在PubMed/Medline国际数据库中对文献进行了系统的回顾，WebofScience(WoS),Scopus,Embase,和Cochrane图书馆从2013年到2022年6月。确定了90项观察性研究，报告了由于药物相关不良事件和NPSs而终止治疗的数据。
■由于NPSs导致的停药率随着治疗时间的增加而增加，根据审查的研究，与使用BIC/恩曲他滨/富马酸替诺福韦艾拉酚胺（BIC/FTC/TAF）治疗的患者相比，使用基于DTG的方案治疗的PLHIV患者更高。这些信息可能对临床医生在治疗决策过程中有用，降低停药率，从而促进治疗的成功和耐久性。此外,在开始治疗前确定PLHIV的潜在危险因素也有助于根据每个个体的特征做出最佳治疗选择.
