Evidence map›Paper›PMID 29973058›Full record

ArticleAIDS research and human retroviruses2018

CYP2B6 Genetic Polymorphisms, Depression, and Viral Suppression in Adults Living with HIV Initiating Efavirenz-Containing Antiretroviral Therapy Regimens in Uganda: Pooled Analysis of Two Prospective Studies.

Jonathan L Chang, Sulggi A Lee, Alexander C Tsai, Nicholas Musinguzi, Conrad Muzoora, Bosco Bwana, Yap Boum, Jessica E Haberer, Peter W Hunt, Jeff Martin and 3 more

Abstract read
In one paragraph

Article in AIDS research and human retroviruses, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Efavirenz Metabolism: Influence of Polymorphic CYP2B6 Variants and Stereochemistry.Drug metabolism and disposition: the biological fate of chemicals · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Jonathan L Chang1 Duke University School of Medicine , Durham, North Carolina.
Sulggi A Lee3 Department of Medicine, University of California , San Francisco, California.
Alexander C Tsai2 Center for Global Health , Massachusetts General Hospital, Boston, Massachusetts.
Nicholas Musinguzi6 Mbarara University of Science and Technology , Mbarara, Uganda .
Conrad Muzoora6 Mbarara University of Science and Technology , Mbarara, Uganda .
Bosco Bwana6 Mbarara University of Science and Technology , Mbarara, Uganda .
Yap Boum7 Epicentre Mbarara , Mbarara, Uganda .
Jessica E Haberer2 Center for Global Health , Massachusetts General Hospital, Boston, Massachusetts.
Peter W Hunt3 Department of Medicine, University of California , San Francisco, California.
Jeff Martin3 Department of Medicine, University of California , San Francisco, California.
David R Bangsberg6 Mbarara University of Science and Technology , Mbarara, Uganda .
Deanna L Kroetz10 Department of Bioengineering and Therapeutic Sciences, University of California , San Francisco, California.
Mark J Siedner2 Center for Global Health , Massachusetts General Hospital, Boston, Massachusetts.

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI RAJESH T GANDHI · 2004 to 2026
$94.4M
Virology CoreP30AI027763 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Monica Gandhi · 1988 to 2026
$93.6M
TB PREVENTION AND HIV IN THE HOMELESS--AN INTERVENTIONR01MH054907 · NIMH · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI BANGSBERG, DAVID ROY · 1995 to 2014
$20.7M
West Coast AIDS and Cancer Specimen Resource (ACSR)U01CA066529 · NCI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI MCGRATH, MICHAEL SHANNON · 1994 to 2012
$16.1M
Behavioral Aspects of Low-cost Medical Devices to Improve HIV CareK23MH099916 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI SIEDNER, MARK J · 2013 to 2017
$917k
NCI NIH HHS U01 CA066529NIAID NIH HHS P30 AI027763NIAID NIH HHS P30 AI060354NIMH NIH HHS K23 MH099916NIMH NIH HHS R01 MH054907
6 · The paper itself

Abstract

Single-nucleotide polymorphisms (SNPs) in CYP2B6 have been shown to predict variation in plasma efavirenz concentrations, but associations between these SNPs and efavirenz-mediated depression and viral suppression are less well described. We evaluated three SNPs in CYP2B6 (rs3745274, rs28399499, and rs4803419) in Ugandan persons living with HIV. To define exposure, we used previously published pharmacokinetic modeling data to categorize participants as normal, intermediate, and poor efavirenz metabolizers. Our outcomes were probable depression in the first 2 years after antiretroviral therapy (ART) initiation (mean score of >1.75 on the Hopkins Symptom Depression Checklist) and viral suppression 6 months after ART initiation. We fit generalized estimating equation and modified Poisson regression models adjusted for demographic, clinical, and psychosocial characteristics with or without individuals with depression at the time of ART initiation. Among 242 participants, there were no differences in the pre-ART depression or viral load by efavirenz metabolism strata (p > .05). Participants were classified as normal (32%), intermediate (50%), and poor (18%) metabolizers. Seven percent (56/242) of follow-up visits met criteria for depression. Eighty-five percent (167/202) of participants who completed a 6-month visit achieved viral suppression. CYP2B6 metabolizer strata did not have a statistically significant association with either depression [adjusted risk ratio (aRR) comparing intermediate or poor vs. normal, 1.46; 95% confidence interval (CI), 0.72-2.95] or 6-month viral suppression (aRR, 1.01; 95% CI, 0.88-1.15). However, in analyses restricted to participants without pre-ART depression, poorer CYP2B6 metabolism was associated with increased odds of depression (adjusted odds ratio, 4.11; 95% CI, 1.04-16.20). Efavirenz-metabolizing allele patterns are strongly associated with risk of incident depression. Future work should elucidate further region-specific gene-environment interactions and whether alternate polymorphisms may be associated with efavirenz metabolism.

Indexed as

AdultAlkynesAnti-HIV AgentsBenzoxazinesCyclopropanesCytochrome P-450 CYP2B6Cytochrome P-450 CYP2B6 InducersDepressionFemaleGenotypeHIVHIV InfectionsHumansMaleOdds RatioPolymorphism, Single NucleotideAlkynesAnti-HIV AgentsBenzoxazinesCyclopropanesCYP2B6 protein, humanCytochrome P-450 CYP2B6Cytochrome P-450 CYP2B6 InducersefavirenzCYP2B6depressionefavirenzHIVsingle-nucleotide polymorphismsviral suppression

Identifiers

PMID29973058
PMCPMC6238612

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.