Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors

Leserman, Jane; Petitto, John M.; Gu, Hongbin; Gaynes, Bradley N.; Barroso, Julie; Golden, Robert N.; Perkins, Diana O.; Folds, James D.; Evans, Dwight L.

doi:10.1017/s0033291702005949

Cited by 263 publications

(224 citation statements)

References 57 publications

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“…Thus, specific impairments in NK cell function may compromise the host's natural resistance against HIV. These HIV effects on NK cell function, coupled with the reports of reduced NK cell activity in depression, including depressed HIV-infected individuals, could underlie the findings from studies suggesting that depression adversely affects HIV disease progression in prospective clinical investigations of HIV-seropositive individuals (11,13,14,17,18,(86)(87)(88).…”

Section: Discussionmentioning

confidence: 97%

Selective Serotonin Reuptake Inhibitor and Substance P Antagonist Enhancement of Natural Killer Cell Innate Immunity in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

Evans

Lynch

Benton

et al. 2008

Biological Psychiatry

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Background-Natural killer (NK) cells play an important role in innate immunity and are involved in the host defense against human immunodeficiency virus (HIV) infection. This study examines the potential role of three underlying regulatory systems that have been under investigation in central nervous system research as well as immune and viral research: serotonin, neurokinin, and glucocorticoid systems.

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Section: Discussionmentioning

confidence: 97%

Selective Serotonin Reuptake Inhibitor and Substance P Antagonist Enhancement of Natural Killer Cell Innate Immunity in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

Evans

Lynch

Benton

et al. 2008

Biological Psychiatry

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“…Given that previous investigations have found stress to be related to HIV disease progression, we had expected to find a relationship between stress and viral load. 3,42 Although perceived stress was associated with suboptimal treatment adherence, the magnitude of this relationship may not have been strong enough to impact viral load. Alternatively, because our participants were at various stages of the disease, it is possible that the relationship between stress and viral load is better examined using a measure of change in viral load rather than a discrete measurement of viral load.…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has illustrated that people living under stressful conditions frequently engage in poor health practices, which ultimately increase their risk for disease and disease progression. 1,2 Moreover, Leserman and colleagues 3 have demonstrated that life stress hastens AIDS diagnosis among HIV-positive individuals. However, contrary to the original study hypotheses, physiologic measures, including cortisol levels and lymphocyte subsets (CD8 and natural killer [NK] cells), did not mediate or moderate the relationship between life stress and AIDS diagnosis.…”

Section: Introduction Tmentioning

confidence: 99%

Life Stress and Adherence to Antiretroviral Therapy among HIV-Positive Individuals: A Preliminary Investigation

Bottonari

Roberts

Ciesla

et al. 2005

AIDS Patient Care and STDs

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The present study sought to investigate the impact of life stress on treatment adherence and viral load of HIV-positive individuals. Three different aspects of life stress were examined in this investigation (perceived stress, acute life events unrelated to the HIV illness, and HIVrelated acute life events). Furthermore, we examined whether these relationships were moderated by depressive severity, self-esteem, and neuroticism. Participants (n ‫؍‬ 24) were treatment-seeking HIV-positive individuals who completed a series of questionnaires for this investigation. The majority of the participants in this sample were middle-aged, Caucasian males who identified themselves as either homosexual or bisexual, had contracted HIV via sexual contact, and met criteria for AIDS (mean CD4 count ‫؍‬ 324). This sample was highly self-selected and varied from the county HIV-positive population in terms of gender, ethnicity, and HIV risk factor. Information on their adherence and viral load was collected from their medical records 6 to 9 months after completion of the psychological measurements. Results indicated that perceived stress, but not acute events, prospectively predicted adherence. Moreover, marginal trends suggested that depressive symptoms and neuroticism moderated the effect of perceived stress on adherence. Neither perceived stress nor acute life events were associated with viral load. 719

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“…These hormonal imbalances cause suppression of Th-1 cytokines which are associated with HIV progression (Clerici et al 1997;Norbiato et al 1997). Leserman et al (2002), showed that a 3 μg/dl increase in cumulative average cortisol (equal to one standard deviation change) resulted in a 40% increased risk of progression to AIDS, using blood samples gathered from a cohort of HIV-positive men (Leserman et al 2002). This study also examined the relationship between number of stressful life events and progression to AIDS, finding for each one point increase in cumulative average stressful life events, the risk of progressing to AIDS increased by 14% (Leserman et al 2002).…”

Section: Stress and Progression From Hiv To Aidsmentioning

confidence: 99%

Population Levels of Psychological Stress, Herpesvirus Reactivation and HIV

2008

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Nearly 40,000 Americans are newly infected with Human Immunodeficiency Virus (HIV) each year. Recently, studies have demonstrated associations between group-level characteristics and the prevalence and incidence of HIV/Acquired Immune Deficiency Syndrome (AIDS) and other sexually transmitted diseases. Two mechanisms previously posited to explain these associations are neighborhood effects on risk behaviors and social or institutional policies. In this paper, we hypothesize that adversity at the population level, such as neighborhood poverty, also influences HIV risk through stress-mediated aberrations in immunological susceptibility by reviewing existing data examining each of these pathways. In particular, we review the evidence showing that: (1) Neighborhood ecologic stressors influence neighborhood-and individual-levels of mental health, psychosocial stress, and HIV/AIDS risk, (2) Individual-level psychosocial stressors influence progression from HIV to AIDS through stress-related hormonal changes, and (3) Individual-level psychosocial stressors influence HIV acquisition via stress-related reactivation of latent herpesviruses, specifically EBV and HSV-2. Our review indicates that further studies are needed to examine the joint pathways linking neighborhood-level sources of psychosocial stress, stress-related reactivation of HSV-2 and EBV, and increased acquisition rates of HIV. We suggest using a multi-level framework for targeting HIV prevention efforts that address not only behavioral risk factors, but structural, political, and institutional factors associated with neighborhood disadvantage, levels of psychosocial stress, and prevention or treatment of HSV-2 and EBV.

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Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors

Abstract: These results suggest that stressful life events, dysphoric mood and limited social support are associated with more rapid clinical progression in HIV infection, with serum cortisol also exerting an independent effect on disease progression.

Cited by 263 publications

References 57 publications

Selective Serotonin Reuptake Inhibitor and Substance P Antagonist Enhancement of Natural Killer Cell Innate Immunity in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

Selective Serotonin Reuptake Inhibitor and Substance P Antagonist Enhancement of Natural Killer Cell Innate Immunity in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome

Life Stress and Adherence to Antiretroviral Therapy among HIV-Positive Individuals: A Preliminary Investigation

Population Levels of Psychological Stress, Herpesvirus Reactivation and HIV

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