People with HIV starting treatment regimens containing Sustiva (efavirenz) have a more than doubled risk of suicidal thoughts, attempts and completed attempts, when compared with those beginning Sustiva-free regimens, MedPage Today reports. Publishing their findings in the Annals of Internal Medicine, researchers examined data on 5,332 initially treatment-naive HIV-positive members of four different AIDS Clinical Trials Group studies.

The participants were randomly assigned to begin antiretroviral (ARV) regimens either with Sustiva (3,241 participants) or without (2,091 participants). The median follow-up time was 96 weeks.

The study defined suicidality as suicidal thoughts, or attempted or completed suicide. There were 47 participants who reported suicidality in the Sustiva group, for a rate of 8.08 per 1,000 person-years, compared with 15 participants who did so in the non-Sustiva group, for a rate of 3.66 per 1,000 person-years. Consequently, Sustiva was associated with a 2.28-fold increase in the rate of suicidality. Seventeen participants in the Sustiva group attempted or completed suicide, for a rate of 2.90 per 1,000 person-years, compared with five in the Sustiva-free group, for a rate of 1.22 per 1,000 person-years. Thus, those taking Sustiva had a 2.58-fold increased likelihood of attempted or completed suicide. A total of eight people in the Sustiva group committed suicide, compared with one in the Sustiva-free group.

The study is limited by the fact that there was no standard questionnaire about suicidal ideations or attempts. Also, three of the four studies were open label, meaning participants knew which drugs they were taking.  

To read the MedPage Today story, click here.

To read the study abstract, click here.