Cocaine Use May be Associated with Increased Depression in Persons Infected with HIV.
Cocaine Use May be Associated with Increased Depression in Persons Infected with HIV.
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DOI：
10.1007/s10461-015-1187-7
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发表时间：
2016-02
影响因子：
4.4
通讯作者：
Treisman GJ
中科院分区：
文献类型：
--
作者：
Hammond ER;Lai S;Wright CM;Treisman GJ
HIV 感染、抑郁症和可卡因使用与炎症信号产生的增加独立相关。越来越多的证据表明炎症在抑郁症中的作用。在 HIV 疾病中，使用可卡因可能会加速疾病进展并改变 T 细胞功能，导致细胞因子激活，从而增加抑郁症的易感性。我们在 2003 年 8 月至 2012 年 12 月期间参加了马里兰州巴尔的摩市的一项观察性研究，对 447 名经常吸食可卡因或不吸食可卡因的非裔美国人 HIV 感染者进行了可卡因使用与抑郁症之间的关联性调查。抑郁症的总体患病率为 40.9%（447 名参与者中的 183 名）。在抑郁症患者中，可卡因使用率为 81.4%（183 人中的 149 人），而非抑郁症患者中可卡因使用率为 69.3%（264 人中的 183 人），P=0.004。使用可卡因与抑郁症发病率增加近 2 倍相关，未调整的比值比 (OR)=1.94（95% CI：1.23，3.06）；与从未使用可卡因相比，P=0.004，OR=1.02（95% CI：1.10，1.05）；调整后的分析中 P=0.04。观察到可卡因使用时间的增加与抑郁症之间存在剂量反应关系。使用可卡因的频率和持续时间可能与抑郁症有关。我们推测感染艾滋病毒的可卡因使用者的抑郁症可能涉及炎症成分，需要进一步检查。
HIV infection, depression, and cocaine use are independently associated with increased inflammatory signal production. There is increasing evidence about the role of inflammation in depression. In HIV disease, cocaine use may increase disease progression as well as alter T-cell functioning resulting in cytokine activation and thereby increasing susceptibility to depression. We examined the association between cocaine use and depression among 447 African American persons infected with HIV who were frequent cocaine users or non-users, enrolled in an observational study in Baltimore, Maryland, between August 2003 and December 2012. The overall prevalence of depression was 40.9% (183 of 447) participants. Among persons who were depressed, the prevalence of cocaine use was 81.4% (149 of 183), compared to 69.3% among persons who were not depressed (183 of 264), P=0.004. Cocaine use was associated with nearly 2-fold increased odds of depression, unadjusted odds ratio (OR)=1.94, (95% CI: 1.23, 3.06); P=0.004, compared to never using cocaine, and OR=1.02, (95% CI: 1.10, 1.05); P=0.04 in adjusted analysis. A dose-response relationship between increasing duration of cocaine use and depression was observed. Frequency and duration of cocaine use may be associated with depression. We speculate that depression among cocaine users with HIV may involve an inflammatory component that needs further examination.