Can HIV Infection Increases the Risk of Death Associated with Depressive Symptoms

William Kellogg
April 22, 2019

Despite numerous attempts to finding the most promising and effective drugs to manage depression, the disorder remains the most frequently reported mental health condition in people living with HIV in the U.S, and  even globally, the prevalence of HIV continues on the increase with a prevalence ranging from twenty (20) to forty (40) percent. Depressive disorders have been associated with increased mortality in persons with chronic diseases such as heart disease, end-stage renal disease and diabetes. These comorbidities have made the management of any of the following conditions really challenging for caregivers and even more challenging for patients. Patients are subjects of many drug-drug interactions and adverse drug reactions since these patients often have to use multiple medications. Another way the disorder is impacting the healthcare system is increased labor and institutional cost. While it true that depression presents with many other pathological disorders for which numerous studies have confirmed, the association between depression and infectious diseases on the other hand has not been extensively studied.

Recently, in a study aimed to investigate the link among the wide range of depressive disorders or symptoms, HIV status of a patient and mortality, scientists discovered that symptoms of depression are moderately associated with death among veterans with HIV but not among those without HIV infection.

Several studies have described similar associations within the context of HIV infection, but available data remains conflicting and incomplete.

The researchers from Boston University School of Medicine (BUSM were able to gather data from participants of the Veteran’s Aging Cohort Study, researchers). The researchers were able to compare the risk of death among U.S. Veterans who were depressed to those not suffering with depression. They then studied the relationship between depression/depressive symptoms and death among those infected with HIV to those without HIV. Depression was measured in two ways using clinical diagnostic codes and depressive symptoms questionnaire.

Among those with HIV infection, they were able to discover a 23 percent increased mortality risk associated with elevated depressive symptoms ascertained by the questionnaire but no significantly increased mortality risk when depression was ascertained by the codes. For HIV-uninfected people, there was a six percent increased mortality risk associated with depressive disorders measured by the codes but no significant increased mortality risk for elevated depressive symptoms assessed by the questionnaire.

According to corresponding author Kaku So-Armah, PhD, assistant professor of medicine at BUSM,   important to screen for and treat depression particularly among those living with HIV due to the observation that important therapeutic progress, improved life-expectancy, and improved quality of life have been made through intervention with lifesaving antiretroviral. The results of their findings strengthened the need to assess and treat depressive symptoms and major depressive disorder in patients with and without HIV infection with the aim of reducing mortality risk. The researchers were able to discover that despite clinical guidelines recommending routine screening for depressive symptoms, there is varying success in implementation resulting in under diagnosis of depression among people with HIV infection.

The researchers stressed the importance of better understanding of barriers to and facilitators of effective depression screening. They also pointed out that the integration of depression treatment into HIV primary care will be necessary to improve the quality of life of patients.

William Kellogg

William Kellogg is a veteran writer who's covered the subject of the intersection of technology, health and mental wellness for nearly two decades.

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