The Double Burdens of Mental Health Among AIDS Patients With Fully Successful Immune Restoration: A Cross-Sectional Study of Anxiety and Depression in China

Abstract

Background: Anxiety and depression continue to be significant comorbidities for people with HIV infection. We investigated the prevalence of and factors associated with anxiety and depression among adult HIV-infected patients across China.Methods: In this cross-sectional study, we described clinical and psychosocial variables related to depression and anxiety in 4103 HIV-infected persons. Doctors assessed anxiety and depression by asking patients whether they had experienced anxiety or depression in the prior month. Patients also self-administered the Hospital Anxiety and Depression (HAD) scale; those with score ≥8 on HAD-A/D were considered to be at high risk of anxiety or depression.Results: Associations between socio-demographic, psychosocial, and ART-related clinical factors and risk of depression or anxiety were investigated using multivariable logistic regression. Among patients assessed between 9/2014 and 11/2015, 27.4% had symptoms of anxiety, 32.9% had symptoms of depression, and 19.0% had both. Recentness of HIV diagnoses (P = 0.046) was associated with elevated odds of anxiety. Older age (P = 0.004), higher educational attainment (P < 0.001), employment (P = 0.001), support from family / friends (P < 0.001), and sleep disturbance (P < 0.001), and number of ART regimen switches (P = 0.046) were associated with risk of depression, while neither sex nor transmission route showed any associations. There were no significant associations with HIV-specific clinical factors including current CD4+ T cell count and current viral load.Conclusions: Prevalence of symptoms of anxiety and depression is high in this cohort of treatment-experienced HIV patients. Psychological and social-demographic factors, rather than HIV disease status, were associated with risk of depression and anxiety. This finding highlights the need to deliver interventions to address the mental health issues affecting HIV-infected persons with fully successful immune restoration across China.

Pharmacodynamics of efavirenz 400 mg in treatment-naïve Chinese HIV-infected patients in a prospective cohort study

“…Thus, we assessed sleep quality and depression by the PSQI and HAMD scales in this study, nding that the quality of sleep in participants was satisfactory and that no participants developed depression. This nding was not consistent with previous literature documenting symptoms of depression existing in 32.9% of HIVinfected adults on treatment in China [30]. This discrepancy may be due to the following reasons.…”

Pharmacodynamics of efavirenz 400mg in treatment-naïve Chinese HIV-infected patients in a prospective cohort study

“…Thus we assessed the sleep quality and depression by PSQI and HAMD in this study, nding the quality of sleep in participants was satisfactory and nobody developed depression. This nding was not consistent with previous literature documenting symptoms of depression existing in 32.9% HIV-infected adults on treatment in China [25] . This discrepancy may be due to following reasons: First, dose reduction contributed to reduce the CNS toxicity and improve patients' long-term tolerance.…”

Neuropsychiatric Adverse Events During 12 Months of Treatment with Efavirenz in a Treatment-Naïve HIV-Infected Population in China: A Prospective Cohort Study

“…In our study, we found that baseline anxiety, depression, and sleep disorders were the most important predictors associated with NPAEs in patients treated with EFV. In addition, sociological factors such as education level, marital status, and employment status were also associated with severe psychological abnormalities during treatment, consistent with previous studies [42,43]. Since HIV/AIDS has become a chronic, manageable disease with the advent of highly effective ART, mental health management is required as an integral component effective of HIV/AIDS care [44].…”