Role of depression, stress, and trauma in HIV disease progression
Role of depression, stress, and trauma in HIV disease progression
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DOI：
10.1097/psy.0b013e3181777a5f
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发表时间：
2008-06-01
影响因子：
3.3
通讯作者：
Leserman, Jane
中科院分区：
文献类型：
--
作者：
Leserman, Jane
尽管艾滋病毒治疗取得了进展，但这种疾病的进展仍然存在很大的差异。本文综述了抑郁、压力性生活事件和创伤是HIV病程变异的原因。回顾了高效抗逆转录病毒疗法（HAART）出现之前和之后的纵向研究。为了确保完整的综述，检索了PubMed从1990年1月到2007年7月的所有英文文章。我们发现了大量一致的证据表明，慢性抑郁症，应激事件和创伤可能会对HIV疾病的进展产生负面影响，包括CD 4 T淋巴细胞减少，病毒载量增加以及临床下降和死亡的风险增加。需要更多的研究来调查这些心理免疫关系的生物和行为介质，以及可能减轻慢性抑郁和创伤对健康的负面影响的干预措施。鉴于艾滋病毒/艾滋病感染者抑郁症和过去创伤的发生率很高，医疗保健提供者必须将这些问题作为标准艾滋病毒护理的一部分。
Despite advances in HIV treatment, there continues to be great variability in the progression of this disease. This paper reviews theevidence that depression, stressful life events, and trauma account for some of the variation in HIV disease course. Longitudinal studies both before and after the advent of highly active antiretroviral therapies (HAART) are reviewed. To ensure a complete review, PubMed was searched for all English language articles from January 1990 to July 2007. We found substantial and consistent evidence that chronic depression, stressful events, and trauma may negatively affect HIV disease progression in terms of decreases in CD4 T lymphocytes, increases in viral load, and greater risk for clinical decline and mortality. More research is warranted to investigate biological and behavioral mediators of these psychoimmune relationships, and the types of interventions that might mitigate the negative health impact of chronic depression and trauma. Given the high rates of depression and past trauma in persons living with HIV/AIDS, it is important for healthcare providers to address these problems as part of standard HIV care.