Psychological risk factors for HIV pathogenesis: Mediation by the autonomic nervous system
Psychological risk factors for HIV pathogenesis: Mediation by the autonomic nervous system
复制标题
DOI：
10.1016/s0006-3223(02)01888-7
复制
发表时间：
2003-12-15
影响因子：
10.6
通讯作者：
Naliboff, BD
中科院分区：
文献类型：
--
作者：
Cole, SW;Kemeny, ME;Naliboff, BD
背景资料：流行病学研究已经确定了特定的身体疾病的心理危险因素，但介导这些关系的生物学机制仍然不明确defined.Methods：社会抑制和自主神经系统（ANS）的活动进行了评估，在多个场合在54男同性恋者无症状的人类免疫缺陷病毒（HIV）感染。基线ANS评估后，血浆HIV-1病毒载量和CD 4 + T细胞水平进行了监测12-18个月，以评估ANS活性和HIV pathogenicity.Results之间的关系：我们证实了以前报道的社会抑制气质和病毒病理脆弱性之间的关系。血浆病毒载量设定点升高8倍，在社会抑制的个人，这些人表现出较差的病毒学和免疫学反应，启动高效抗逆转录病毒治疗（HAART）。影响独立于感染持续时间，HAART方案，人口统计学特征和健康相关行为。神经生理学评估记录提高ANS活动在社会抑制的个人，和mediational分析表明，这种差异可以解释64%-92%的社会抑制和病毒学parameters.Conclusions之间的协方差：这些数据提供了第一个临床证据表明，差异神经活动介导的心理危险因素和传染病发病机制之间的关系。这些发现也为HIV-1疾病的长期控制提供了新的靶点。
Background: Epidemiologic studies have identified psychological risk factors for specific physical diseases, but the biological mechanisms mediating these relationships remain poorly defined.Methods: Social inhibition and autonomic nervous system (ANS) activity were assessed on multiple occasions in 54 gay men with asymptomatic human immunodeficiency virus (HIV) infection. Following baseline ANS assessment, plasma HIV-1 viral load and CD4+ T cell levels were monitored for 12-18 months to assess relationships between ANS activity and HIV pathogenesis.Results: We confirmed the previously reported relationship between socially inhibited temperament and vulnerability to viral pathology. Plasma viral load set-point was elevated eight-fold in socially inhibited individuals, and these individuals showed poorer virologic and immunologic response to initiation of highly active antiretroviral therapy (HAART). Effects were independent of duration of infection, HAART regimen, demographic characteristics, and health-relevant behavior. Neurophysiologic assessments documented elevated ANS activity in socially inhibited individuals, and mediational analyses showed that such differences could account for 64%-92% of the covariance between social inhibition and virologic parameters.Conclusions: These data provide the first clinical evidence that differential neural activity mediates relationships between psychological risk factors and infectious disease pathogenesis. Such findings also suggest novel targets for adjunctive therapy in long-term control of HIV-1 disease.