Association Between Depressive Symptom Patterns and Clinical Profiles Among Persons Living with HIV

Abstract

To describe patterns of depressive symptoms across 10-years by HIV status and to determine the associations between depressive symptom patterns, HIV status, and clinical profiles of persons living with HIV from the Multicenter AIDS Cohort Study (N = 980) and Women's Interagency HIV Study (N = 1744). Group-based trajectory models were used to identify depressive symptoms patterns between 2004 and 2013. Multinomial logistic regressions were conducted to determine associations of depression risk patterns. A 3-group model emerged among HIV-negative women (low: 58%; moderate: 31%; severe: 11%); 5-groups emerged among HIV-positive women (low: 28%; moderate: 31%; high: 25%; decreased: 7%; severe: 9%). A 4-group model emerged among HIV-negative (low: 52%; moderate: 15%; high: 23%; severe: 10%) and HIV-positive men (low: 34%; moderate: 34%; high: 22%; severe: 10%). HIV+ women had higher odds for moderate (adjusted odds ratio [AOR] 2.10, 95% CI 1.63-2.70) and severe (AOR 1.96, 95% CI 1.33-2.91) depression risk groups, compared to low depression risk. HIV+ men had higher odds for moderate depression risk (AOR 3.23, 95% CI 2.22-4.69), compared to low risk. The Framingham Risk Score, ART use, and unsuppressed viral load were associated with depressive symptom patterns. Clinicians should consider the impact that depressive symptoms may have on HIV prognosis and clinical indicators of comorbid illnesses.

Modelling of viral load dynamics and CD4 cell count progression in an antiretroviral naive cohort: using a joint linear mixed and multistate Markov model

“…Having multiple sexual partners significantly increased patients' viral load throughout the follow-up time. This might be due to patients with high-risk behaviors, such as an increased number of sexual partners, have been associated with depression [44], and patient with chronic depression was significantly associated with an increase in viral load [45]. In other words, viral load has a mediating effect through depression caused by having multiple sexual partners.…”

Longitudinal trajectories of emotional problems and unmet mental health needs among people newly diagnosed with HIV in China

“…Although an overwhelming majority of cross-sectional studies have demonstrated the prevalence and related factors of depression and anxiety among people living with HIV, the results have been fragmentary and inconsistent [12][13][14][15]. Findings of the few existing longitudinal studies have also been mixed [16][17][18][19][20][21][22]. Some studies have found an increase in depression and anxiety over time [16][17][18] others have found the prevalence to decline [19] or remain stable [20][21][22].…”

“…Findings of the few existing longitudinal studies have also been mixed [16][17][18][19][20][21][22]. Some studies have found an increase in depression and anxiety over time [16][17][18] others have found the prevalence to decline [19] or remain stable [20][21][22]. These conflicting results may be due to differences in the sample characteristics, particularly the different disease courses of HIV infection [4,5].…”

HIV and symptoms of depression are independently associated with impaired glucocorticoid signaling

“…Depression co-morbid with HIV infection has emerged as a predictor of HIV-related comorbidities (Kelso-Chichetto et al 2017, Rivera-Rivera et al 2014, Rivera-Rivera et al 2016) and increased mortality (Ickovics et al 2001). Although the precise mechanistic relationship between depression and HIV-related comorbidities has not been elucidated, the biological relationship between inflammation and depression may be a critical factor (Valdez et al 2016).…”

“…In seronegative individuals, a bidirectional relationship between depression and inflammation has been established such that inflammation increases the risk of depression (Miller et al 2009) and psychosocial stress and negative mood increase inflammation (Glaser & Kiecolt-Glaser 2005). Although not as well characterized in the context of HIV infection, depression and HIV-related comorbidities are more prevalent in women than in men (Kelso-Chichetto et al 2017), and middle-aged women living with HIV (WLWH) are at increased risk for systemic immune activation/inflammation compared to men living with HIV (MWLH) (Raghavan et al 2017).…”