Mental health disorders and the risk of AIDS-defining illness and death in HIV-infected veterans

Nurutdinova, Diana; Chrusciel, Timothy; Zeringue, Angelique; Scherrer, Jeffrey F.; Al‐Aly, Ziyad; McDonald, Jay R.; Overton, Edgar Turner

doi:10.1097/qad.0b013e32834e1404

Cited by 57 publications

(37 citation statements)

References 37 publications

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“…Several studies found increased cytotoxic CD8 T-cell activation and lower natural killer cell activity in HIV-infected individuals with clinical depression,13 14 while others found a higher risk of AIDS with increasing serum cortisol levels, a steroid hormone associated with depression 15 16. In contrast, one study in US veterans found no evidence of an association between depressive symptoms and mortality or AIDS-defining illness after adjustment for combination ART, while another, conducted prior to the availability of ART, found no association between depressive symptoms and accelerated mortality or worse medical outcome 3 17…”

Section: Introductionmentioning

confidence: 99%

Depression, adherence and attrition from care in HIV-infected adults receiving antiretroviral therapy

Krumme

Kaigamba

Binagwaho

et al. 2014

J Epidemiol Community Health

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Section: Introductionmentioning

confidence: 99%

Depression, adherence and attrition from care in HIV-infected adults receiving antiretroviral therapy

Krumme

Kaigamba

Binagwaho

et al. 2014

J Epidemiol Community Health

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“…In a large cohort study of HIV-infected veterans, 34% had one or more psychiatric disease diagnoses [14]. It is estimated that approximately half of HIV-infected patients have major depressive symptoms and 20%–25% meet diagnostic criteria for a depressive disorder [15].…”

Section: Introductionmentioning

confidence: 99%

Cost of Care for HIV-Infected Patients with Co-Occurring Substance Use Disorder or Psychiatric Disease: Report from a Large, Integrated Health Plan

DeLorenze

Tsai

Horberg³

et al. 2014

AIDS Research and Treatment

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Background. The costs of providing care to HIV-infected (HIV+) patients with co-occurring diagnoses of substance use (SU) disorder or psychiatric disease (PD) are not well documented. It is our objective to evaluate costs in these HIV+ patients receiving care in a large health plan. Methods. We conducted a retrospective cohort study from 1995 to 2010 to compare costs of healthcare in HIV+ patients with and without co-occurring SU disorder and/or PD diagnoses. Estimates of proportional differences in costs (rate ratios) were obtained from repeated measures generalized linear regression. Models were stratified by cost category (e.g., inpatient, outpatient). Results. Mean total healthcare costs per patient per year were higher in HIV+ patients diagnosed with SU disorder or PD compared to HIV+ patients without these comorbid conditions. After controlling for confounders, total mean costs remained significantly higher in patients diagnosed with SU disorder (RR = 1.24, 95% CI = 1.18–1.31) or PD (RR = 1.19, 95% CI = 1.15–1.24). Mean outpatient care costs were significantly greater in patients with both SU disorder and PD (RR = 1.52, 95% CI = 1.41–1.64). Conclusions. Given these higher expenditures in the care of HIV+ patients with comorbid SU disorder and/or PD, greater efforts to facilitate SU disorder or PD treatment initiation and persistence could provide substantial savings.

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“…(Nurutdinova et al, 2012) Differences in present findings may reflect the differences in study populations. This sample of HIV infected Medicaid beneficiaries without SMI may be more disadvantaged and medically ill than the HIV-infected VA samples without SMI.…”

Section: Discussionmentioning

confidence: 64%

“…(Himelhoch et al, 2007); (Nurutdinova et al, 2012); (Walkup et al, 2010). This increased prevalence of SMI among individuals with HIV is thought to be secondary to the higher prevalence of substance abuse and HIV transmission risk behaviors, including unprotected sex and exchange sex among persons with SMI.…”

Section: Introductionmentioning

confidence: 99%

Is serious mental illness associated with earlier death among persons with human immunodeficiency virus (HIV)? A ten year follow up in Maryland Medicaid recipients

et al. 2012

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Background/Objective In the general population serious mental illness (SMI) is associated with earlier mortality. The objective of this study was to determine if SMI was associated with an increased risk of death among Maryland Medicaid beneficiaries with HIV. Methods This was a retrospective cohort study of adult Maryland Medicaid recipients with HIV receiving antiretroviral therapy (ART) after January 1, 1997. SMI was defined as a specialty mental health visit and an ICD-9 diagnosis of 1) schizophrenia or related psychoses, 2) bipolar disorder or 3) major depressive disorder. Cox proportional hazards regression models were used to estimate the hazard ratios for total mortality. Analyses were adjusted for demographic characteristics, % days on ART, outpatient visits and comorbid medical conditions. Results Overall, 623 individuals received ART after treatment inception. The total number of deaths was 278, out of which 60 deaths were in the SMI group (38.5%) and 211 in the non-SMI group (45%) (p=0.05). In multivariable analysis, SMI was not associated with mortality. Increasing age, AIDS defining illness, renal failure, cerebrovascular disease, congestive heart failure, chronic liver disease and substance abuse were independently associated with mortality, while increased percent days of HIV medication use and number of outpatient medical visits were associated with improved survival. Conclusions In this sample, SMI is not associated with earlier death in patients with HIV infection. ART use and primary care engagement among HIV infected individuals are associated with improved survival irrespective of an SMI diagnosis.

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Mental health disorders and the risk of AIDS-defining illness and death in HIV-infected veterans

Cited by 57 publications

References 37 publications

Depression, adherence and attrition from care in HIV-infected adults receiving antiretroviral therapy

Depression, adherence and attrition from care in HIV-infected adults receiving antiretroviral therapy

Cost of Care for HIV-Infected Patients with Co-Occurring Substance Use Disorder or Psychiatric Disease: Report from a Large, Integrated Health Plan

Is serious mental illness associated with earlier death among persons with human immunodeficiency virus (HIV)? A ten year follow up in Maryland Medicaid recipients

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