AIM:To determine if efforts to improve antiretroviral therapy(ART)adherence minimizes the negative impact of depression on human immunodeficiency virus(HIV)outcomes.METHODS:A cross-sectional study of a clinic-based co...AIM:To determine if efforts to improve antiretroviral therapy(ART)adherence minimizes the negative impact of depression on human immunodeficiency virus(HIV)outcomes.METHODS:A cross-sectional study of a clinic-based cohort of 158 HIV seropositive(HIV+)African Americans screened for major depressive disorder(MDD)in 2012.CD4 T lymphocyte(CD4+)counts were obtained from these individuals.Self-report on adherence to ART was determined from questionnaire administered during clinic visits.The primary outcome measure was conditional odds of having a poorer CD4+count(<350 cells/mm3).Association between CD4+count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders.RESULTS:Out of 147 individuals with available CD4+T lymphocyte data,31%had CD4+count<350 cells/mm^3 and 28%reported poor ART adherence.As expected the group with>350 cells/mm^3 CD4+T lymphocyte endorsed significantly greater ART adherence compared to the group with<350 cells/mm3 CD4+T lymphocyte count(P<0.004).Prevalence of MDD was 39.5%and 66%of individuals with MDD took antidepressants.Poor CD4+T lymphocyte count was associated with poor ART adherence and MDD.Adjusting for ART adherence,age,sex and education,which were potential confounders,the association between MDD and poor CD4+T lymphocyte remained significant only in the untreated MDD group.CONCLUSION:Therefore,CD4+count could be a clinical marker of untreated depression in HIV+.Also,mental health care may be relevant to primary care of HIV+patients.展开更多
基金Supported by In whole with Federal funds from the National Cancer Institute,National Institutes of Health,under Contract,No.HHSN261200800001E
文摘AIM:To determine if efforts to improve antiretroviral therapy(ART)adherence minimizes the negative impact of depression on human immunodeficiency virus(HIV)outcomes.METHODS:A cross-sectional study of a clinic-based cohort of 158 HIV seropositive(HIV+)African Americans screened for major depressive disorder(MDD)in 2012.CD4 T lymphocyte(CD4+)counts were obtained from these individuals.Self-report on adherence to ART was determined from questionnaire administered during clinic visits.The primary outcome measure was conditional odds of having a poorer CD4+count(<350 cells/mm3).Association between CD4+count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders.RESULTS:Out of 147 individuals with available CD4+T lymphocyte data,31%had CD4+count<350 cells/mm^3 and 28%reported poor ART adherence.As expected the group with>350 cells/mm^3 CD4+T lymphocyte endorsed significantly greater ART adherence compared to the group with<350 cells/mm3 CD4+T lymphocyte count(P<0.004).Prevalence of MDD was 39.5%and 66%of individuals with MDD took antidepressants.Poor CD4+T lymphocyte count was associated with poor ART adherence and MDD.Adjusting for ART adherence,age,sex and education,which were potential confounders,the association between MDD and poor CD4+T lymphocyte remained significant only in the untreated MDD group.CONCLUSION:Therefore,CD4+count could be a clinical marker of untreated depression in HIV+.Also,mental health care may be relevant to primary care of HIV+patients.
