The association between the use of efavirenz and the occurrence of depressive disorders among HIV-treated patients: An application of Bayesian cox regression

Issue title: Selected papers from the 9th International Multi-Conference on Engineering and Technology Innovation 2019 (IMETI2019)

Guest editors: Wen-Hsiang Hsieh

Article type: Research Article

Authors: Lai, Yi-Horng^{; *}

Affiliations: Department of Healthcare Administration, Oriental Institute of Technology, New Taipei City, Taiwan

Correspondence: [*] Corresponding author. Yi-Horng Lai, Department of Healthcare Administration, Oriental Institute of Technology, New Taipei City, Taiwan. E-mail: FL006@mail.oit.edu.tw.

Abstract: OBJECTIVES:Efavirenz therapy plays an important role in controlling the progression of HIV/AIDS. However, efavirenz often causes short-term side effects for the central nervous system, and it remained controversial as to whether efavirenz leads to depression or even suicidal attempt when applied for a longer period of time. The purpose of this study is to determine the association between the use of efavirenz and depressive disorders. METHODS:This study explored the use of efavirenz on HIV-infected patients using National Health Insurance Research Database (NHIRD) in Taiwan by Bayesian survival analysis and investigated whether the use of efavirenz has the risk of depressive disorders. To reduce the dependence of statistical modeling assumptions, this study applied propensity score matching to research data. RESULTS:Based on the result of this study, it can be found that the use of efavirenz (HR = 1.009, 95% CI=–0.505 0.554), gender (HR = 0.324, 95% CI = –2.544 0.381) were not significantly associated with the occurrence of depressive disorders, whereas age of HIV diagnosis (HR = 1.021, 95% CI = 0.011 0.055) was significantly associated with the occurrence of depressive disorders. This study concludes that the use of efavirenz does not in-crease the risk of depressive disorders among HIV-treated patients. CONCLUSIONS:For the care of HIV-infected patients (especially the older ones), the psychological harm from society, such as lack of social support, social stigma or unemployment is higher than the harm of medicine.

Keywords: Human immunodeficiency virus (HIV), active antiretroviral therapy, depressive disorder, propensity score matching, Bayesian cox regression

DOI: 10.3233/JIFS-189628

Journal: Journal of Intelligent & Fuzzy Systems, vol. 40, no. 4, pp. 8053-8062, 2021