Cognitive Performance, as well as Depression, Alcohol Use, and Gender, predict Anti-Retroviral Therapy Adherence in a South African Cohort of People with HIV and Comorbid Major Depressive Disorder.
Cognitive Performance, as well as Depression, Alcohol Use, and Gender, predict Anti-Retroviral Therapy Adherence in a South African Cohort of People with HIV and Comorbid Major Depressive Disorder.
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认知表现以及抑郁症，饮酒和性别，可以预测南非艾滋病毒和合并症主要抑郁症患者的抗逆转录病毒疗法的依从性。
DOI：
10.1007/s10461-023-03992-7
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发表时间：
2023-08
影响因子：
4.4
通讯作者：
Joska, John
中科院分区：
文献类型：
--
作者：
Dreyer, Anna J.;Nightingale, Sam;Andersen, Lena S.;Lee, Jasper S.;Gouse, Hetta;Safren, Steven A.;O'Cleirigh, Conall;Thomas, Kevin G. F.;Joska, John
抑郁症和认知障碍，这通常共存于艾滋病毒感染者（PWH），已被确定为最佳抗逆转录病毒治疗（ART）依从性的潜在障碍。我们调查了南非一个患有重度抑郁症（MDD）的PWH队列的认知表现、抑郁（以及其他社会人口学、心理社会学和精神病学变量）与ART依从性之间的相关性。认知能力和ART依从性在间隔8个月的两个时间点进行评估（N基线= 105，N随访= 81）。通过自我报告、客观测量（Wisepill使用和血浆替诺福韦二磷酸水平）和HIV病毒抑制来指示依从性。混合效应回归模型检查了两个时间点之间的关联。单变量模型检测到认知表现（全球和域内）和ART依从性之间没有显着关联。多变量模型显示，抑郁严重程度增加（β =-0.54，p < 0.001）和有问题的饮酒（β = 0.73，p = 0.015）与主观测量的依从性较差相关。如病毒抑制所示，女性（OR 0.27，p = 0.048）和具有更好的整体认知能力（OR 1.83，p = 0.043）与更好的依从性相关。这项研究确定了不良的整体认知能力，以及抑郁症和有问题的酒精使用，作为潜在的障碍，以最佳的ART坚持PWH和共病MDD。因此，临床医生可以考虑评估认知缺陷，抑郁症和有问题的酒精使用，并应努力提供适当的支持，以提高依从性。
Depression and cognitive impairment, which commonly coexist in people with HIV (PWH), have been identified as potential barriers to optimal antiretroviral therapy (ART) adherence. We investigated associations between cognitive performance, depression (as well as other sociodemographic, psychosocial and psychiatric variables) and ART adherence in a South African cohort of PWH with comorbid major depressive disorder (MDD). Cognitive performance and ART adherence were assessed at two time points 8 months apart (Nbaseline = 105, Nfollow-up = 81). Adherence was indicated by self-report, objective measures (Wisepill usage and plasma tenofovir-diphosphate levels), and HIV viral suppression. Mixed-effects regression models examined associations across both time points. Univariate models detected no significant associations between cognitive performance (globally and within-domain) and ART adherence. Multivariate modelling showed increased depression severity (β = − 0.54, p < 0.001) and problematic alcohol use (β = 0.73, p = 0.015) were associated with worse adherence as measured subjectively. Being female (OR 0.27, p = 0.048) and having better global cognitive performance (OR 1.83, p = 0.043) were associated with better adherence as indicated by viral suppression. This study identifies poor global cognitive performance, as well as depression and problematic alcohol use, as potential barriers to optimal ART adherence in PWH and comorbid MDD. Hence, clinicians could consider assessing for cognitive deficits, depression, and problematic alcohol use, and should endeavour to provide the appropriate support so as to improve adherence.
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影响因子：
9.4
作者：
Damond, F.;Roquebert, B.;Descamps, D.
通讯作者：
Descamps, D.
影响因子：
4.4
作者：
Braganca, Miguel;Palha, Antonio
通讯作者：
Palha, Antonio
影响因子：
2.9
作者：
Caballero, Joshua;Ownby, Raymond L.;Schweizer, Mark S.
通讯作者：
Schweizer, Mark S.
DOI：
10.1097/qai.0b013e31827ed678
发表时间：
2013-03-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Andrade AS;Deutsch R;A Celano S;Duarte NA;Marcotte TD;Umlauf A;Atkinson JH;McCutchan JA;Franklin D;Alexander TJ;McArthur JC;Marra C;Grant I;Collier AC
通讯作者：
Collier AC
影响因子：
4.6
作者：
Castillo-Mancilla JR;Haberer JE
通讯作者：
Haberer JE