Risk of clinically significant depression in <scp>HIV</scp>‐infected patients: effect of antiretroviral drugs

Gutiérrez, Félix; García, L.; Padilla, Sergio; Moreno, Santiago; Navarro, Gemma; Gómez-Sirvent, J.L.; Vidal, Francesc; Asensi, Vı́ctor; Masiá, Mar; CoRIS,

doi:10.1111/hiv.12104

Cited by 35 publications

(22 citation statements)

References 34 publications

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“…Efavirenz, a frequently prescribed non-nucleoside reverse-transcriptase inhibitor, is known to have neurological side effects. We therefore performed preliminary analyses of time-updated/lagged regimen types by drug classes and by use of efavirenz but, as other studies suggest, we also did not find evidence for associations with incident depression [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 94%

Frequency of and Risk Factors for Depression among Participants in the Swiss HIV Cohort Study (SHCS)

et al. 2015

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ObjectivesWe studied the incidence and prevalence of, and co-factors for depression in the Swiss HIV Cohort Study.MethodsDepression-specific items were introduced in 2010 and prospectively collected at semiannual cohort visits. Clinical, laboratory and behavioral co-factors of incident depression among participants free of depression at the first two visits in 2010 or thereafter were analyzed with Poisson regression. Cumulative prevalence of depression at the last visit was analyzed with logistic regression.ResultsAmong 4,422 participants without a history of psychiatric disorders or depression at baseline, 360 developed depression during 9,348 person-years (PY) of follow-up, resulting in an incidence rate of 3.9 per 100 PY (95% confidence interval (CI) 3.5–4.3). Cumulative prevalence of depression during follow-up was recorded for 1,937/6,756 (28.7%) participants. Incidence and cumulative prevalence were higher in injection drug users (IDU) and women. Older age, preserved work ability and higher physical activity were associated with less depression episodes. Mortality (0.96 per 100 PY, 95% CI 0.83–1.11) based upon 193 deaths over 20,102 PY was higher among male IDU (2.34, 1.78–3.09), female IDU (2.33, 1.59–3.39) and white heterosexual men (1.32, 0.94–1.84) compared to white heterosexual women and homosexual men (0.53, 0.29–0.95; and 0.71, 0.55–0.92). Compared to participants free of depression, mortality was slightly elevated among participants with a history of depression (1.17, 0.94–1.45 vs. 0.86, 0.71–1.03, P = 0.033). Suicides (n = 18) did not differ between HIV transmission groups (P = 0.50), but were more frequent among participants with a prior diagnosis of depression (0.18 per 100 PY, 95%CI 0.10–0.31; vs. 0.04, 0.02–0.10; P = 0.003).ConclusionsDepression is a frequent co-morbidity among HIV-infected persons, and thus an important focus of care.

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Section: Discussionmentioning

confidence: 94%

Frequency of and Risk Factors for Depression among Participants in the Swiss HIV Cohort Study (SHCS)

et al. 2015

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“…Notably, the prevalence of documented depression in this study (5.6% of women in the cohort and 17.0% of men) differs from that reported in other cohorts (56.1% of HIV-positive women with depressive symptoms in the Women’s Interagency HIV Study compared to 21.0% of HIV-positive men in the Multicenter AIDS Cohort Study [ 26 ]), suggesting that depression may have been underascertained among female neuro-AIDS patients in this study and/or that neuro-AIDS severity and progression in female patients precluded psychiatric diagnoses. Notably, a recent cohort study assessing the impact of ART on clinically significant depression in the Spanish AIDS Research Network also found no statistically significant difference in the incidence of depression between male and female participants, although there was a non-significant trend favoring a higher incidence among women (adjusted incidence rate ratio = 1.45, 95% CI: 0.96–2.18, p = 0.074) [ 27 ]. While the findings regarding sex, depression, and survival in the current study should be interpreted with caution, additional research should certainly be undertaken to explore this relationship further.…”

Section: Discussionmentioning

confidence: 99%

Differential Survival for Men and Women with HIV/AIDS-Related Neurologic Diagnoses

et al. 2015

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ObjectivesNeurologic complications of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) frequently lead to disability or death in affected patients. The aim of this study was to determine whether survival patterns differ between men and women with HIV/AIDS-related neurologic disease (neuro-AIDS).MethodsRetrospective cohort data from a statewide surveillance database for HIV/AIDS were used to characterize survival following an HIV/AIDS-related neurologic diagnosis for men and women with one or more of the following conditions: cryptococcosis, toxoplasmosis, primary central nervous system lymphoma, progressive multifocal leukoencephalopathy, and HIV-associated dementia. A second, non-independent cohort was formed using university-based cases to confirm and extend the findings from the statewide data. Kaplan-Meier analysis was used to compare the survival experiences for men and women in the cohorts. Cox regression was employed to characterize survival while controlling for potential confounders in the study population.ResultsWomen (n=27) had significantly poorer outcomes than men (n=198) in the statewide cohort (adjusted hazard ratio=2.31, 95% CI: 1.22 to 4.35), and a similar, non-significant trend was observed among university-based cases (n=17 women, 154 men). Secondary analyses suggested that this difference persisted over the course of the AIDS epidemic and was not attributable to differential antiretroviral therapy responses among men and women.ConclusionsThe survival disadvantage of women compared to men should be confirmed and the mechanisms underlying this disparity elucidated. If this relationship is confirmed, targeted clinical and public health efforts might be directed towards screening, treatment, and support for women affected by neuro-AIDS.

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“…The widespread clinical use of antiretroviral drugs has improved the survival time of HIV-1-infected patients significantly. 3,4 HIV-1/AIDS is becoming a chronic disease that can be gradually controlled. 5 In China, approximately 50 000 patients are newly diagnosed with HIV-1 yearly.…”

Section: Introductionmentioning

confidence: 99%

Sepsis risk factors associated with HIV-1 patients undergoing surgery

Feng

Xiu-ling

Jiang

et al. 2015

Emerging Microbes & Infections

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Recent developments in the treatment of HIV-1 have improved the disease prognosis from a terminal disease to a chronic disease. The number of HIV-1-infected patients who require surgery has become more common. The main threat to HIV-1-infected patients following surgery is the development of sepsis. In this study, we collected a large number of clinical recordings of HIV-1-infected patients from two hospitals in China, specializing in HIV-1 treatment in order to summarize the risk indicators of sepsis in HIV-1-infected patients. We compared the significant risk indicators between the sepsis and non-sepsis groups. Using logistic regression based on the indicators of four separate surgery-based diseases, we generally found that low CD4 and hypoalbuminemia counts prior to surgery were the significant risk factors for developing sepsis. The morbidity of sepsis in trauma patients was approximately 10 times higher than the dysfunction group, whereas the tumor and the infection groups were approximately 1.5 and 2 times higher, respectively. Based on the comparison between the sepsis and non-sepsis groups for each surgery-based disease, we found that the severity of trauma is a critical risk factor for trauma patients; therefore, limiting the size of the wound during surgery is crucial. HIV-1-infected patients often develop postoperative sepsis due to immunodeficiency and complications due to the surgery. We hope that this study can help to reduce the risk of developing sepsis due to surgery and improve the survival rate of HIV-1-infected patients.

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Risk of clinically significant depression in HIV‐infected patients: effect of antiretroviral drugs

Cited by 35 publications

References 34 publications

Frequency of and Risk Factors for Depression among Participants in the Swiss HIV Cohort Study (SHCS)

Frequency of and Risk Factors for Depression among Participants in the Swiss HIV Cohort Study (SHCS)

Differential Survival for Men and Women with HIV/AIDS-Related Neurologic Diagnoses

Sepsis risk factors associated with HIV-1 patients undergoing surgery

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