Effects of depression and selective serotonin reuptake inhibitor use on adherence to highly active antiretroviral therapy and on clinical outcomes in HIV-infected patients
| Autor: | Michael A. Horberg, Michael J. Silverberg, Drew Kovach, Winkler G. Weinberg, Wayne Thomas Dodge, Diana Antoniskis, Charles P. Quesenberry, Daniel B. Klein, Robert Dobrinich, Leo B. Hurley, Susan J. Bersoff-Matcha, Miguel Mogyoros, William J. Towner |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
Male medicine.medical_specialty Serotonin reuptake inhibitor HIV Infections Cohort Studies Acquired immunodeficiency syndrome (AIDS) Internal medicine Antiretroviral Therapy Highly Active Odds Ratio Medicine Humans Pharmacology (medical) Depression (differential diagnoses) Retrospective Studies Depressive Disorder biology business.industry virus diseases Retrospective cohort study Odds ratio Middle Aged biology.organism_classification medicine.disease CD4 Lymphocyte Count Regimen Infectious Diseases Logistic Models Immunology Lentivirus HIV-1 Patient Compliance RNA Viral Female business Selective Serotonin Reuptake Inhibitors Cohort study |
| Zdroj: | Journal of acquired immune deficiency syndromes (1999). 47(3) |
| ISSN: | 1525-4135 |
| Popis: | To determine the impact of depression on highly active antiretroviral therapy (HAART) adherence and clinical measures and investigate if selective serotonin reuptake inhibitors (SSRIs) improve these measures.Retrospective cohort study.In 2 large health maintenance organizations, we measured the effects of depression (with and without SSRI use) on adherence and changes in viral and immunologic control among HIV-infected patients starting a new HAART regimen. HAART adherence, HIV RNA levels, and changes in CD4 T-cell counts through 12 months were measured.A total of 3359 patients were evaluated; 42% had a depression diagnosis, and 15% used SSRIs during HAART. Depression without SSRI use was associated with significantly decreased odds of achievingor =90% adherence to HAART (odds ratio [OR] = 0.81, 95% confidence interval [CI]: 0.70 to 0.98; P = 0.03). Depression was associated with significantly lower odds of an HIV RNA level500 copies/mL (OR = 0.77, 95% CI: 0.62 to 0.95; P = 0.02). Depressed patients compliant with SSRI medication (80% adherence to SSRI) had HAART adherence and viral control statistically similar to nondepressed HIV-infected patients taking HAART. Comparing depressed with nondepressed HIV-infected patients, CD4 T-cell responses were statistically similar; among depressed patients, those compliant with SSRI had statistically greater increases in CD4 cell responses.Depression significantly worsens HAART adherence and HIV viral control. Compliant SSRI use is associated with improved HIV adherence and laboratory parameters. |
| Databáze: | OpenAIRE |
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