Relation of lifetime trauma and depressive symptoms to mortality in HIV
Relation of lifetime trauma and depressive symptoms to mortality in HIV
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DOI：
10.1176/appi.ajp.2007.06111775
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发表时间：
2007-11-01
影响因子：
17.7
通讯作者：
Stangl, Dalene
中科院分区：
文献类型：
--
作者：
Leserman, Jane;Pence, Brian Wells;Stangl, Dalene
目的：在一个高活性抗逆转录病毒疗法的时代，作者需要证实以前的发现，即压力和抑郁对艾滋病的进展有影响。本研究的目的是检查终身创伤、近期压力事件和抑郁对艾滋病毒感染男性和女性全因死亡率和艾滋病相关死亡率的影响。作者假设，这些社会心理变量将预测显着更快的艾滋病毒特异性和全因mortality.Method：作者连续采样艾滋病毒感染的男性和女性谁收到的护理在8个传染病诊所在美国东南部5个州。样本包括490例患者，随访27个月，并与他们的医疗记录长达41 months.Results：有29例死亡，16例与艾滋病有关。更多的终身创伤和辅助/诱导T细胞（CD 4）抗原标记< 200显著预测更快的全因和艾滋病相关死亡率。对于那些处于或高于创伤中位数的人，全因死亡率为每100人年3.54人，而低于中位数的人为1.72人。对于那些处于或高于创伤中位数的人，艾滋病相关死亡率为每100人年2.13人，而低于中位数的人为0.77人。抑郁症状和更高的基线病毒载量显着相关的艾滋病相关mortality.Conclusions的风险更大：需要进一步的研究，以确定是否干预措施，以解决创伤和抑郁症可以修改这些有害的影响对HIV。
Objective: in an era of highly active antiretroviral therapies, the authors needed to confirm previous findings showing that stress and depression have an impact on HIV disease progression. The goal of the current study was to examine the effects of lifetime trauma, recent stressful events, and depression on all-cause and AIDS-related mortality among HIV-infected men and women. The authors hypothesized that these psychosocial variables would predict significantly faster HIV-specific and all-cause mortality.Method: The authors consecutively sampled HIV-infected men and women who received care at one of eight infectious diseases clinics in five Southeastern states. The sample included 490 patients who were followed by interview for 27 months and followed with their medical records for up to 41 months.Results: There were 29 deaths; 16 were AIDS-related. More lifetime trauma and antigenic marker on helper/inducer T cells (CD4) < 200 significantly predicted faster all-cause and AIDS-related mortality. For those at or above the median in trauma, the all-cause death rate was 3.54 per 100 person-years, compared to 1.72 for those below the median. For those at or above the median in trauma, the AIDS-related death rate was 2.13 per 100 person-years, compared to 0.77 for those below the median. Depressive symptoms and higher baseline viral load were significantly related to greater risk of AIDS-related mortality.Conclusions: Further research is needed to determine if interventions to address trauma and depression can modify these detrimental effects on HIV.