The effect of depressive symptoms at ART initiation on HIV clinical progression and mortality : implications in clinical practice
Depression is common in HIV-infected patients receiving antiretroviral therapy. However, longitudinal studies addressing the role that depression might play in HIV clinical progression and mortality remain rare. This is especially true for those studies that also consider the possible confounding in...
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| Veröffentlicht in: | Antiviral therapy 2007, Vol.12 (7), p.1067-1074 |
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| creator | VILLES, Virginie SPIRE, Bruno LEWDEN, Charlotte PERRONNE, Christian BESNIER, Jean-Marc GARRE, Michel CHENE, Geneviève LEPORT, Catherine PATRIZIA CARRIERI, Maria LE MOING, Vincent |
| description | Depression is common in HIV-infected patients receiving antiretroviral therapy. However, longitudinal studies addressing the role that depression might play in HIV clinical progression and mortality remain rare. This is especially true for those studies that also consider the possible confounding influence of patient's adherence to treatment.
The ANRS CO-8 APROCO-COPILOTE cohort study enrolled 1,281 individuals at the initiation of a protease-inhibitor-containing regimen between 1997 and 1999. Adherence, depressive symptoms and other psychosocial factors were measured using self-administered questionnaires. Predictors of progression to AIDS or death were studied using Cox models.
Out of 1,028 individuals eligible for the present analysis, 92 individuals either died or had an AIDS-defining event during a median follow up of 54 months. At baseline, 377 individuals (41%) reported depressive symptoms and 124 (12%) reported non-adherence at month 4. Depressive symptoms at baseline were associated with progression (hazard ratio [HR] 2.1; P = 0.001). Despite the association between depressive symptoms and nonadherence, depressive symptoms remained a predictor of clinical progression (adjusted HR [aHR] [95% confidence interval (CI)] 1.6 [1.0-2.5]) after adjustment for several factors: initial non-adherence (aHR [95% CI] 2.0 [1.1-3.6]), having a steady partner (aHR [95% CI] 0.5 [0.3-0.7]), older age (aHR [95% CI] 1.40 [1.12-1.74] per 10-year increment), HIV clinical stage C (aHR [95% CI] 2.5 [1.6-4.0]), plasma HIV RNA > or = 100,000 copies/ml (aHR [95% CI] 1.7 [1.1-2.87]) and more than 8 years since HIV diagnosis (aHR [95% CI] 1.8 [1.1-2.8]).
Depressive symptoms and non-adherence are independent predictors of HIV clinical progression and mortality. Screening and appropriate treatment of depressive symptoms at antiretroviral treatment initiation should be included in the standard care of HIV-infected patients. |
| doi_str_mv | 10.1177/135965350701200705 |
| format | Article |
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The ANRS CO-8 APROCO-COPILOTE cohort study enrolled 1,281 individuals at the initiation of a protease-inhibitor-containing regimen between 1997 and 1999. Adherence, depressive symptoms and other psychosocial factors were measured using self-administered questionnaires. Predictors of progression to AIDS or death were studied using Cox models.
Out of 1,028 individuals eligible for the present analysis, 92 individuals either died or had an AIDS-defining event during a median follow up of 54 months. At baseline, 377 individuals (41%) reported depressive symptoms and 124 (12%) reported non-adherence at month 4. Depressive symptoms at baseline were associated with progression (hazard ratio [HR] 2.1; P = 0.001). Despite the association between depressive symptoms and nonadherence, depressive symptoms remained a predictor of clinical progression (adjusted HR [aHR] [95% confidence interval (CI)] 1.6 [1.0-2.5]) after adjustment for several factors: initial non-adherence (aHR [95% CI] 2.0 [1.1-3.6]), having a steady partner (aHR [95% CI] 0.5 [0.3-0.7]), older age (aHR [95% CI] 1.40 [1.12-1.74] per 10-year increment), HIV clinical stage C (aHR [95% CI] 2.5 [1.6-4.0]), plasma HIV RNA > or = 100,000 copies/ml (aHR [95% CI] 1.7 [1.1-2.87]) and more than 8 years since HIV diagnosis (aHR [95% CI] 1.8 [1.1-2.8]).
Depressive symptoms and non-adherence are independent predictors of HIV clinical progression and mortality. Screening and appropriate treatment of depressive symptoms at antiretroviral treatment initiation should be included in the standard care of HIV-infected patients.</description><identifier>ISSN: 1359-6535</identifier><identifier>EISSN: 2040-2058</identifier><identifier>DOI: 10.1177/135965350701200705</identifier><identifier>PMID: 18018765</identifier><language>eng</language><publisher>London: International Medical Press</publisher><subject>Adult ; Adult and adolescent clinical studies ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiretroviral Therapy, Highly Active ; Antiviral agents ; Biological and medical sciences ; Cohort Studies ; Depression ; Depression - psychology ; Disease Progression ; Female ; HIV Infections - mortality ; HIV Infections - physiopathology ; HIV Infections - psychology ; HIV Infections - virology ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; Kaplan-Meier Estimate ; Longitudinal Studies ; Male ; Medical sciences ; Mood disorders ; Pharmacology. Drug treatments ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Surveys and Questionnaires ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids</subject><ispartof>Antiviral therapy, 2007, Vol.12 (7), p.1067-1074</ispartof><rights>2007 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c2905-6ea957e531d2d1f24b4154a907afa3422e40ece2cb174dfb01c4cb93a3122f4a3</citedby><cites>FETCH-LOGICAL-c2905-6ea957e531d2d1f24b4154a907afa3422e40ece2cb174dfb01c4cb93a3122f4a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=19237810$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18018765$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>VILLES, Virginie</creatorcontrib><creatorcontrib>SPIRE, Bruno</creatorcontrib><creatorcontrib>LEWDEN, Charlotte</creatorcontrib><creatorcontrib>PERRONNE, Christian</creatorcontrib><creatorcontrib>BESNIER, Jean-Marc</creatorcontrib><creatorcontrib>GARRE, Michel</creatorcontrib><creatorcontrib>CHENE, Geneviève</creatorcontrib><creatorcontrib>LEPORT, Catherine</creatorcontrib><creatorcontrib>PATRIZIA CARRIERI, Maria</creatorcontrib><creatorcontrib>LE MOING, Vincent</creatorcontrib><creatorcontrib>ANRS CO-8 APROCO-COPILOTE Study Group</creatorcontrib><title>The effect of depressive symptoms at ART initiation on HIV clinical progression and mortality : implications in clinical practice</title><title>Antiviral therapy</title><addtitle>Antivir Ther</addtitle><description>Depression is common in HIV-infected patients receiving antiretroviral therapy. However, longitudinal studies addressing the role that depression might play in HIV clinical progression and mortality remain rare. This is especially true for those studies that also consider the possible confounding influence of patient's adherence to treatment.
The ANRS CO-8 APROCO-COPILOTE cohort study enrolled 1,281 individuals at the initiation of a protease-inhibitor-containing regimen between 1997 and 1999. Adherence, depressive symptoms and other psychosocial factors were measured using self-administered questionnaires. Predictors of progression to AIDS or death were studied using Cox models.
Out of 1,028 individuals eligible for the present analysis, 92 individuals either died or had an AIDS-defining event during a median follow up of 54 months. At baseline, 377 individuals (41%) reported depressive symptoms and 124 (12%) reported non-adherence at month 4. Depressive symptoms at baseline were associated with progression (hazard ratio [HR] 2.1; P = 0.001). Despite the association between depressive symptoms and nonadherence, depressive symptoms remained a predictor of clinical progression (adjusted HR [aHR] [95% confidence interval (CI)] 1.6 [1.0-2.5]) after adjustment for several factors: initial non-adherence (aHR [95% CI] 2.0 [1.1-3.6]), having a steady partner (aHR [95% CI] 0.5 [0.3-0.7]), older age (aHR [95% CI] 1.40 [1.12-1.74] per 10-year increment), HIV clinical stage C (aHR [95% CI] 2.5 [1.6-4.0]), plasma HIV RNA > or = 100,000 copies/ml (aHR [95% CI] 1.7 [1.1-2.87]) and more than 8 years since HIV diagnosis (aHR [95% CI] 1.8 [1.1-2.8]).
Depressive symptoms and non-adherence are independent predictors of HIV clinical progression and mortality. Screening and appropriate treatment of depressive symptoms at antiretroviral treatment initiation should be included in the standard care of HIV-infected patients.</description><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Depression</subject><subject>Depression - psychology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>HIV Infections - mortality</subject><subject>HIV Infections - physiopathology</subject><subject>HIV Infections - psychology</subject><subject>HIV Infections - virology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>Kaplan-Meier Estimate</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mood disorders</subject><subject>Pharmacology. Drug treatments</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Surveys and Questionnaires</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. Aids</subject><issn>1359-6535</issn><issn>2040-2058</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkM1KJDEUhYOMaNv6ArOQbMZdOTd_XVXuRBwVBEFat8Wt1I0TqT8raaGX8-ampxsUhJBA8n2Hm8PYTwHnQuT5b6FMuTDKQA5CQtrNHptJ0JBJMMUPNtsA2YY4ZEchvALIogQ4YIeiAFHkCzNj_5Z_iZNzZCMfHG9onCgE_048rLsxDl3gGPnl45L73keP0Q89T-v27pnbNt1ZbPk4DS__tfSAfcO7YYrY-rjmF9x3Y5ugjRdSxlcJbfSWjtm-wzbQye6cs6c_18ur2-z-4ebu6vI-s7IEky0IS5OTUaKRjXBS11oYjSXk6FBpKUkDWZK2FrluXA3CaluXCpWQ0mlUc3a2zU3Tvq0oxKrzwVLbYk_DKlSLwoiUUyZQbkE7DSFM5Kpx8h1O60pAtSm--l58kk536au6o-ZT2TWdgF87AEP6vpuwtz58cqVUeSFAfQDu04wO</recordid><startdate>2007</startdate><enddate>2007</enddate><creator>VILLES, Virginie</creator><creator>SPIRE, Bruno</creator><creator>LEWDEN, Charlotte</creator><creator>PERRONNE, Christian</creator><creator>BESNIER, Jean-Marc</creator><creator>GARRE, Michel</creator><creator>CHENE, Geneviève</creator><creator>LEPORT, Catherine</creator><creator>PATRIZIA CARRIERI, Maria</creator><creator>LE MOING, Vincent</creator><general>International Medical Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2007</creationdate><title>The effect of depressive symptoms at ART initiation on HIV clinical progression and mortality : implications in clinical practice</title><author>VILLES, Virginie ; SPIRE, Bruno ; LEWDEN, Charlotte ; PERRONNE, Christian ; BESNIER, Jean-Marc ; GARRE, Michel ; CHENE, Geneviève ; LEPORT, Catherine ; PATRIZIA CARRIERI, Maria ; LE MOING, Vincent</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2905-6ea957e531d2d1f24b4154a907afa3422e40ece2cb174dfb01c4cb93a3122f4a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Depression</topic><topic>Depression - psychology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>HIV Infections - mortality</topic><topic>HIV Infections - physiopathology</topic><topic>HIV Infections - psychology</topic><topic>HIV Infections - virology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>Kaplan-Meier Estimate</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mood disorders</topic><topic>Pharmacology. Drug treatments</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Surveys and Questionnaires</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. Aids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>VILLES, Virginie</creatorcontrib><creatorcontrib>SPIRE, Bruno</creatorcontrib><creatorcontrib>LEWDEN, Charlotte</creatorcontrib><creatorcontrib>PERRONNE, Christian</creatorcontrib><creatorcontrib>BESNIER, Jean-Marc</creatorcontrib><creatorcontrib>GARRE, Michel</creatorcontrib><creatorcontrib>CHENE, Geneviève</creatorcontrib><creatorcontrib>LEPORT, Catherine</creatorcontrib><creatorcontrib>PATRIZIA CARRIERI, Maria</creatorcontrib><creatorcontrib>LE MOING, Vincent</creatorcontrib><creatorcontrib>ANRS CO-8 APROCO-COPILOTE Study Group</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Antiviral therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>VILLES, Virginie</au><au>SPIRE, Bruno</au><au>LEWDEN, Charlotte</au><au>PERRONNE, Christian</au><au>BESNIER, Jean-Marc</au><au>GARRE, Michel</au><au>CHENE, Geneviève</au><au>LEPORT, Catherine</au><au>PATRIZIA CARRIERI, Maria</au><au>LE MOING, Vincent</au><aucorp>ANRS CO-8 APROCO-COPILOTE Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The effect of depressive symptoms at ART initiation on HIV clinical progression and mortality : implications in clinical practice</atitle><jtitle>Antiviral therapy</jtitle><addtitle>Antivir Ther</addtitle><date>2007</date><risdate>2007</risdate><volume>12</volume><issue>7</issue><spage>1067</spage><epage>1074</epage><pages>1067-1074</pages><issn>1359-6535</issn><eissn>2040-2058</eissn><abstract>Depression is common in HIV-infected patients receiving antiretroviral therapy. However, longitudinal studies addressing the role that depression might play in HIV clinical progression and mortality remain rare. This is especially true for those studies that also consider the possible confounding influence of patient's adherence to treatment.
The ANRS CO-8 APROCO-COPILOTE cohort study enrolled 1,281 individuals at the initiation of a protease-inhibitor-containing regimen between 1997 and 1999. Adherence, depressive symptoms and other psychosocial factors were measured using self-administered questionnaires. Predictors of progression to AIDS or death were studied using Cox models.
Out of 1,028 individuals eligible for the present analysis, 92 individuals either died or had an AIDS-defining event during a median follow up of 54 months. At baseline, 377 individuals (41%) reported depressive symptoms and 124 (12%) reported non-adherence at month 4. Depressive symptoms at baseline were associated with progression (hazard ratio [HR] 2.1; P = 0.001). Despite the association between depressive symptoms and nonadherence, depressive symptoms remained a predictor of clinical progression (adjusted HR [aHR] [95% confidence interval (CI)] 1.6 [1.0-2.5]) after adjustment for several factors: initial non-adherence (aHR [95% CI] 2.0 [1.1-3.6]), having a steady partner (aHR [95% CI] 0.5 [0.3-0.7]), older age (aHR [95% CI] 1.40 [1.12-1.74] per 10-year increment), HIV clinical stage C (aHR [95% CI] 2.5 [1.6-4.0]), plasma HIV RNA > or = 100,000 copies/ml (aHR [95% CI] 1.7 [1.1-2.87]) and more than 8 years since HIV diagnosis (aHR [95% CI] 1.8 [1.1-2.8]).
Depressive symptoms and non-adherence are independent predictors of HIV clinical progression and mortality. Screening and appropriate treatment of depressive symptoms at antiretroviral treatment initiation should be included in the standard care of HIV-infected patients.</abstract><cop>London</cop><pub>International Medical Press</pub><pmid>18018765</pmid><doi>10.1177/135965350701200705</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Adult and adolescent clinical studies Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral Therapy, Highly Active Antiviral agents Biological and medical sciences Cohort Studies Depression Depression - psychology Disease Progression Female HIV Infections - mortality HIV Infections - physiopathology HIV Infections - psychology HIV Infections - virology Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases Kaplan-Meier Estimate Longitudinal Studies Male Medical sciences Mood disorders Pharmacology. Drug treatments Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Surveys and Questionnaires Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids |
| title | The effect of depressive symptoms at ART initiation on HIV clinical progression and mortality : implications in clinical practice |
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