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
1   Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Cristina García-Navarro
1   Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Beatriz Ruiz-Saez
2   Molecular Biology and Immunology Laboratory, HIV Spanish Biobank, Hospital Universitario Gregorio Marañón, Madrid, Spain
,
Talía Sainz
3   Department 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
2   Molecular Biology and Immunology Laboratory, HIV Spanish Biobank, Hospital Universitario Gregorio Marañón, Madrid, Spain
,
Pablo Rojo
1   Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
,
María José Mellado Peña
3   Department 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
1   Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Maria Angeles Muñoz-Fernandez
2   Molecular Biology and Immunology Laboratory, HIV Spanish Biobank, Hospital Universitario Gregorio Marañón, Madrid, Spain
,
Berta Zamora
4   Department of Neuropsychology, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Isabel Cuéllar-Flores
5   Department of Psychology/Paediatric, Hospital Universitario Clínico San Carlos, Madrid, Spain
,
Carlos Velo
1   Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
,
Manuela Martin-Bejarano
1   Department of Paediatric Infectious Diseases, Hospital Universitario 12 de Octubre, Madrid, Spain
,
José Tomás Ramos
6   Department of Paediatrics, Hospital Universitario Clínico San Carlos, Madrid, Spain
,
María Luisa Navarro Gómez
7   Department of Paediatric Infectious Diseases, Hospital Universitario Gregorio Marañón, Madrid, Spain
› Author Affiliations
Funding This work was supported by Fundación para la Investigación y Prevención de SIDA en España (FIPSE) [24691/07, 3608229/09, 240800/09, 361910/10 and 36–0910–1]; Red Temática de Investigación en SIDA (RED RIS) [RD16/0025/0017-ISCIII-FEDER, RD16/0025/0019-ISCIII-FEDER, RD16/0025/0024-ISCIII-FEDER and RIS_EPICLIN_07/2016); Fundación Mutua Madrileña [2012/0077], Instituto de Salud Carlos III [FIS 15/00694] which is co-funded by FondoEuropeo de Desarrollo Regional (FEDER): “Una manera de hacer Europa.” TS has been funded by a Research Fellowship by the European Society for Pediatric Infectious Diseases (ESPID) and is now cofunded by the Spanish Ministry of Science and Innovation—Instituto de Salud Carlos III (Contratos Juan Rodés JR16/00021) and Feder-FFE. BRS is currently being funded by the Spanish Ministry of Science and Innovation (Instituto de Salud Carlos IIII, Contratos Rio Hortega specialized health care post-training contract [CM 16/0022]). CV is currently being funded by Comunidad de Madrid and fondos FEDER (Ayudaspara la contratacion de ayudantes de Investigacion y tecnicos de laboratorio/Orden 2524/2016, de 1 de agosto, BOCM núm. 188, de 8 de agosto de 2016).
Further Information

Publication History

25 February 2018

03 September 2018

Publication Date:
13 October 2018 (online)

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.

Financial Disclosure

Authors declare have no financial relationships relevant to this article to disclose.


Appendix of Additional Study Sites and Participants

NeuroCoRISpe project: María Isabel González-Tomé, Pablo Rojo, Daniel Blázquez, Elisa Fernández Cooke, Cristina Epalza, Luis Prieto, Berta Zamora, Cristina García-Navarro, Manuela Martin-Bejarano, Carlos Velo, and Ana Martínez de Aragón (Hospital Doce de Octubre, Madrid); María José Mellado, Luis Escosa, Milagros García Hortelano, and Talía Sainz (Hospital La Paz); José Tomás Ramos and Isabel Cuéllar (Hospital Clínico San Carlos, Madrid); Sara Guillén (Hospital de Getafe); María Luisa Navarro, Jesús Saavedra, Mar Santos, Ma AngelesMuñoz-Fernández, Beatriz Ruiz-Saez, Carolina Fernandez McPhee, Santiago Jiménez de Ory, Susana Álvarez, and Ignacio Rodriguez Izquierdo (Hospital Gregorio Marañón); Claudia Fortuny and Ton Noguera (Hospital Sant Joan de Deu); David Moreno and Esmeralda Núñez (Hospital Carlos Haya); and Olaf Neth and Dolores Falcón (Hospital Virgen del Rocío). This project is included in CoRISpe Cohort Working Group (AIDS Paed Research network): María José Mellado, Luis Escosa, Milagros García Hortelano, Talía Sainz (Hospital La Paz); María Isabel González-Tomé, Pablo Rojo, Daniel Blázquez, Cristina Epalza (Hospital Doce de Octubre, Madrid); José Tomás Ramos (Hospital Clínico San Carlos, Madrid); Luis Prieto, Sara Guillén (Hospital de Getafe); María Luisa Navarro, Jesús Saavedra, Mar Santos, Ma Angeles Muñoz, Beatriz Ruiz, Carolina Fernandez McPhee, Santiago Jimenez de Ory, Itzíar Carrasco, (Hospital Gregorio Marañón); Miguel Ángel Roa (Hospital de Móstoles); José Beceiro, María Penín (Hospital Príncipe de Asturias, Alcalá de Henares); Jorge Martínez (Hospital Niño Jesús, Madrid); Katie Badillo (Hospital de Torrejón); Miren Apilanez (Hospital de Donostia, San Sebastián); Itziar Pocheville (Hospital de Cruces, Bilbao); Elisa Garrote (Hospital de Basurto, Bilbao); Elena Colino (Hospital Insular Materno Infantil, Las Palmas de Gran Canaria); Jorge Gómez Sirvent (Hospital Virgen de la Candelaria, Santa Cruz de Tenerife); Mónica Garzón, Vicente Román (Hospital de Lanzarote); María José Muñoz, Raquel Angulo (Hospital de Poniente, El Ejido); Olaf Neth, Lola Falcón (Hospital Virgen del Rocio, Sevilla); Pedro Terol (Hospital Virgen de la Macarena, Sevilla); Juan Luis Santos (Hospital Virgen de las Nieves, Granada); David Moreno (Hospital Carlos Haya, Málaga); Francisco Lendínez (Hospital de Torrecárdenas, Almería); Ana Grande (Complejo Hospitalario Universitario Infanta Cristina, Badajoz); Francisco José Romero (Complejo Hospitalario de Cáceres); Carlos Pérez (Hospital de Cabueñes, Gijón); María Martínez (Hospital Universitario Central de Asturias); Miguel Lillo (Hospital de Albacete); Begoña Losada (Hospital Virgen de la Salud, Toledo); Mercedes Herranz (Hospital Virgen del Camino, Pamplona); Matilde Bustillo, Carmelo Guerrero (Hospital Miguel Servet, Zaragoza); Pilar Collado (Hospital Clínico Lozano Blesa, Zaragoza); José Antonio Couceiro (Complejo Hospitalario de Pontevedra); Leticia Vila (Complejo Hospitalario Universitario La Coruña); Consuelo Calviño (Hospital Universitario Lucus Augusti de Lugo); Ana Isabel Piqueras, Rafael Bretón, Inmaculada Segarra (Hospital La Fe, Valencia); César Gavilán (Hospital San Juan de Alicante); Elena Montesinos (Hospital General de Valencia); Marta Dapena (Hospital de Castellón); Cristina Álvarez, Beatriz Jiménez (Hospital Marqués de Valdecilla, Santander); Ana Gloria Andrés (Hospital de León); Víctor Marugán, Carlos Ochoa (Hospital de Zamora); Santiago Alfayate, Ana Isabel Menasalvas (Hospital Virgen de la Arrixaca, Murcia); Yolanda Ruiz del Prado (Complejo Hospitalario San Millán-San Pedro, Logroño) and Paediatric HIV-BioBank integrated in the Spanish AIDS Research Network and collaborating Centers.