Assessing incident depression among older people with and without HIV in U.S.
Assessing incident depression among older people with and without HIV in U.S.
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评估美国感染和未感染艾滋病毒的老年人的抑郁事件
DOI：
10.1007/s00127-022-02375-y
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发表时间：
2023
影响因子：
4.4
通讯作者：
Kuo,Yong-Fang
中科院分区：
文献类型：
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作者：
Yu,Xiaoying;Giordano,ThomasP;Baillargeon,Jacques;Westra,JordanR;Berenson,AbbeyB;Raji,MukailaA;Kuo,Yong-Fang
目的尽管艾滋病毒/艾滋病患者 (PLWHA) 的抑郁症患病率明显较高，但有关该人群抑郁症发病率及其相关性的数据却很少。本研究评估了美国老年医疗保险受益人中艾滋病毒感染、年龄和队列时间对按性别划分的抑郁症风险的影响。方法我们使用 5% 的全国代表性医疗保险受益人样本（1996-2015 年）构建了一个回顾性匹配队列。新诊断出的 (n= 1309) 和既往诊断出的 (n= 1057) HIV 患者与最多三名未感染 HIV 的受益人 (n= 6805) 进行单独匹配。使用针对基线协变量进行调整的细灰色模型来评估 HIV 状况对不同性别阶层患抑郁症的影响。结果 PLWHA，尤其是女性，在五年内患抑郁症的风险较高。三个 HIV 暴露组中男性和女性的抑郁相对亚分布风险 (sHR) 不同，表明存在边际显着交互作用 (p= 0.08)。新诊断出的和既往诊断出的艾滋病毒感染者（与未感染艾滋病毒的人相比）的 sHR (95% CI) 男性为 1.6 (1.3, 1.9) 和 1.9 (1.5, 2.4)，女性为 1.5 (1.2, 1.8) 和 1.2 (0.9, 1.7)。患抑郁症的风险随着年龄[sHR 1.3 (1.1, 1.5)、80 + vs. 65–69]和队列期[sHR 1.3 (1.1, 1.5)、2011–2015 vs. 1995–2000]的增加而增加。 结论 HIV感染会增加5年内患抑郁症的风险，特别是在新诊断的HIV患者和女性中。这种风险随着年龄的增长和最近的艾滋病毒流行时期而增加，表明艾滋病毒初级保健需要强有力的心理健康治疗。
PurposeDespite substantially higher prevalence of depression among people living with HIV/AIDS (PLWHA), few data exist on the incidence and correlates of depression in this population. This study assessed the effect of HIV infection, age, and cohort period on the risk of developing depression by sex among older U.S. Medicare beneficiaries.MethodsWe constructed a retrospective matched cohort using a 5% nationally representative sample of Medicare beneficiaries (1996–2015). People with newly diagnosed (n= 1309) and previously diagnosed (n= 1057) HIV were individually matched with up to three beneficiaries without HIV (n= 6805). Fine-Gray models adjusted for baseline covariates were used to assess the effect of HIV status on developing depression by sex strata.ResultsPLWHA, especially females, had higher risk of developing depression within five years. The relative subdistribution hazards (sHR) for depression among three HIV exposure groups differed between males and females and indicated a marginally significant interaction (p= 0.08). The sHR (95% CI) for newly and previously diagnosed HIV (vs. people without HIV) were 1.6 (1.3, 1.9) and 1.9 (1.5, 2.4) for males, and 1.5 (1.2, 1.8) and 1.2 (0.9, 1.7) for females. The risk of depression increased with age [sHR 1.3 (1.1, 1.5), 80 + vs. 65–69] and cohort period [sHR 1.3 (1.1, 1.5), 2011–2015 vs. 1995–2000].ConclusionsHIV infection increased the risk of developing depression within 5 years, especially among people with newly diagnosed HIV and females. This risk increased with older age and in recent HIV epidemic periods, suggesting a need for robust mental health treatment in HIV primary care.