East African HIV care: depression and HIV outcomes
East African HIV care: depression and HIV outcomes
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DOI：
10.1017/gmh.2019.6
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发表时间：
2019-05-31
影响因子：
3.9
通讯作者：
Valcour, V. G.
中科院分区：
文献类型：
--
作者：
Meffert, S. M.;Neylan, T. C.;Valcour, V. G.
抑郁症是艾滋病病毒感染者（PLWH）常见的合并症，与血浆HIV RNA水平升高有关。虽然抑郁症与抗逆转录病毒（ARV）依从性缺陷相关，但很少有数据能更广泛地告知抑郁症与HIV病毒载量之间的关系。乌干达和坦桑尼亚使用流行病学研究中心抑郁量表（CESD）进行抑郁症筛查AFRICOS是一项正在进行的前瞻性纵向队列研究，在包括肯尼亚、坦桑尼亚和乌干达的HIV护理中心招募HIV感染的成年人。这些网站由总统艾滋病紧急救援计划管理。参与者。HIV+个体如果至少18岁，在登记诊所接受HIV护理并同意数据和标本收集，则有资格。主要结果测量。CESD。结果。在2307名参与者中，18-25%达到CESD抑郁阈值。抑郁症与抗逆转录病毒治疗依从性降低相关（OR 0.59，p=0.01）。在三个CESD项目较高的分数与209-282%的高病毒载量显着相关，独立的ARV坚持参与者之间的ARVs 6 months.Conclusions。PLWH抑郁症的CESD患病率高。不同的抑郁症状与病毒载量的增加独立相关，强调了抑郁症综合治疗的必要性。
Importance.Depression is a common co-morbidity for people living with HIV (PLWH) and is associated with elevated plasma HIV RNA levels. While depression correlates with deficits in antiretroviral (ARV) adherence, little data exist to inform the relationship between depression and HIV vial load more broadly.Objective.To examine the relationship between depression and viral load in the African Cohort Study (AFRICOS) independently of ARV adherence.Design.PLWH in Kenya, Uganda and Tanzania underwent screening for depression using the Center for Epidemiologic Studies Depression Scale (CESD) upon enrollment at AFRICOS HIV care sites.Setting.AFRICOS is an ongoing prospective longitudinal cohort study enrolling HIV-infected adults at HIV care centers including sites in Kenya, Tanzania and Uganda. These sites are administered by President's Emergency Plan For AIDS Relief programs.Participants.HIV+ individuals were eligible if they were at least 18 years old, receiving HIV care at the enrolling clinic and consented to data and specimen collection.Main outcome measure.CESD.Results.Among 2307 participants, 18-25% met the CESD threshold for depression. Depression was associated with decreased ARV adherence (OR 0.59, p=0.01). Higher scores on three CESD items were significantly associated with 209-282% higher viral load, independently of ARV adherence among participants on ARVs 6 months.Conclusions.PLWH had high prevalence of depression on the CESD. Diverse depression symptoms were independently associated with increases in viral load, underscoring the need for comprehensive treatment of depression.