HIV in South Africa - depression and CD4 count

Abstract

Objective. Published studies on the prevalence of depressive symptoms using rating scales and the relationship between depression and immune status offer inconsistent results. Depressive symptoms are common and impact on functioning, quality of life, and health status, highlighting the importance of diagnosis and treatment of patients with HIV infection. The aim of the study was to determine the occurrence of depression among HIV-positive patients using the Beck's Depression Inventory (BDI) and to determine a relationship, if any, between depressive symptoms and CD4 count.Method. Forty-one patients aged 18 years or more were recruited from the HIV outpatient clinic. All the subjects completed the 21-item BDI and their CD4 counts were determined. Patients who had a score of 10 or more on the BDI were considered positive for a depressive disorder.Results. More than half (56%) of the study sample had a BDI of ≥ 10 indicating significant symptoms of depression. There was no significant difference in the CD4 counts between the depressed and non-depressed groups (p > 0.05), and no correlation between CD4 counts and BDI scores in the total study sample (r = 0.27, p > 0.05). The affective components of the BDI contributed significantly to the overall BDI score compared with the somatic component (p < 0.05).Conclusion. The evidence from the study supports the BDI as a suitable measure for identifying those patients who meet the Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for minor or major depression. The HIV epidemic is the most serious health challenge in South Africa and it is imperative that HIV-infected patients who complain of fatigue or insomnia be screened routinely for major depression, followed by a structured interview to confirm the diagnosis.

The Association between CD-4 Level, Stress and Depression Symptoms among People Living with HIV/AIDS

“…Depression can affect behaviour and contribute to adherence to therapy so that HIV infection damages immune function. A study by Moosa (2005) recruiting forty-one people aged 18 years or over from an HIV outpatient clinic showed that about 56% of patients in this study had significant depressive symptoms (BDI > 10). However, this study did not find a significant correlation between BDI and CD4 scores (r = 0.274, p > 0.05) [13].…”

“…Describes increasing the severity of the disorder in question. The interpretation of the results is as follows: a score of 5-9 shows normal ups and downs, 10-18 mild to moderate depression; 19-29 moderate to severe depression and 30-63 major depression [13].…”

“…The results of CD4+ T-lymphocyte examination are used as the basis for clinical management and therapy of HIV-infected people. There are three categories of CD4 T-lymphocytes as follows: category 1 (500 cells/μl), category 2 (200-499 cells/μL), and category 3 (< 200 cells/μl) [13].…”

Longitudinal Antiretroviral Adherence in HIV+ Ugandan Parents and Their Children Initiating HAART in the MTCT-Plus Family Treatment Model: Role of Depression in Declining Adherence Over Time

“…In addition, the research assistants administered the Beck Depression Inventory (BDI) to detect depressive symptoms. This instrument has been used elsewhere in sub-Saharan Africa Kagee 2008;Moosa et al 2005) and validated in similar settings (Awaitefe 1988;Steele 2003). The validation studies demonstrated high degrees of reliability and validity of the BDI in these settings.…”

Cross‐sectional study on socio‐demographic and clinical correlates of depression among human immunodeficiency virus‐positive patients inSurat City,WesternIndia

“…The study by Moosa et al . () in South Africa had found no association between CD4 count and depressive symptomatology on the BDI (with a cutoff score of 10 or more being indicative of possible depressive disorder). On the other hand, the study by Kahazura et al .…”