Discussion
TB, sleep disturbances, neurocognitive toxicity, cognitive dysfunction, neurotoxicity, Cognitive dysfunction, depression, peripheral neuropathy, HIV [Peripheral neuropathy
PERIPHERAL NEUROPATHY, SIDE EFFECT
To our knowledge, this is the first paper that provides the frequencies of symptoms of neurocognitive toxicity, including symptoms of depression, poor sleep quality, cognitive dysfunction and peripheral neuropathy, in women with HIV on ART and initiating IPT in pregnancy or 12 weeks postpartum. The study provides an opportunity to determine potential associations between timing of INH for TB preventive therapy and neurotoxicity in the era of EFV-ART. Effects of timing of IPT initiation (during pregnancy versus postpartum) on neurotoxicity and associations of socio-demographic and medical factors with neurotoxicity were evaluated, with particular interest in IPT/EFV co-exposure.The percentage of symptoms of neurocognitive toxicity observed in this study of 12% for depression, 10% for sleep disturbances and 8% for cognitive dysfunction were as expected for perinatal women in the general population. For postpartum depression, it is well documented that approximately 10–15% of all childbearing women are affected [The prevalence of poor sleep quality generally increases with age [Cognitive dysfunction is common in people living with HIV, with up to 36% affected in a study involving non-pregnant adults living with HIV [Peripheral neuropathy is the most common side effect of INH. The low prevalence of peripheral neuropathy observed in this study could be attributable to the recommended supplementation with pyridoxine [In our study, there was no evidence of an association between timing of initiation of IPT during antepartum and postpartum, concomitant with EFV use, and increased frequencies of probable depression, cognitive dysfunction, sleep disturbances or peripheral neuropathy. Pharmacokinetic data from South African pregnant and postpartum women living with HIV found that INH reduced EFV clearance, especially among those with slow NAT2 acetylator status [Cotrimoxazole was the only risk factor associated with probable depression. This association with depression is already documented [