Despite effective antiretroviral therapy (ART), mild cognitive impairment (things like decreased attention span, poorer memory, worse problem-solving ability) remains common in people living with HIV. The reasons for this are poorly understood and little is known about the impact of specific anti-HIV drugs on neurological function. However, efavirenz – one of the most commonly used antiretrovirals (efavirnez is used in for example Truvada and Atripla) – has been associated with sleep disturbances and cognitive disturbances (vivid dreams, trouble sleeping, dizziness). Investigators in Newcastle designed a pilot study involving people taking efavirenz long-term, to see if changing from efavirenz to a different drug regimen would improve cognitive function.
Perhaps disappointly, changing treatment had no impact on cognitive function. Almost all the assessments performed before and after the switch from efavirenz to other drugs had comparable results. However, switching therapy did appear to improve sleep quality for some. Daytime sleepiness did not improve but some people reporting poor sleep quality on efavirenz did experience improvement after switching.
Although this is a small pilot study, it is a very detailed and thorough one, and suggests that despite the problems some people experience with efavirenz (estimated vary, but up to 25% of people taking efavirnez experience some neurological problems with efavirenz), it does not impact cognitive function.
The full article can be read here.