TY - JOUR
T1 - Correlates of depression among US military members infected with the human immunodeficiency virus
AU - Carpenter, Robert J.
AU - Riddle, Mark S.
AU - White, Dennis A.
AU - Ganesan, Anuradha
PY - 2012
Y1 - 2012
N2 - Objective(s): To define the incidence of mental health disorders (MHD) and risk factors associated with incident MHD in an HIV clinic setting with unrestricted access to care and limited confounding due to concomitant injection drug use (IDU). Design: Retrospective cohort study. Methods: Eligible subjects were HIV positive adults followed at a US military treatment facility during the calendar year 2005. Incidence rates are calculated per 100 person years (py). Cox proportional hazards regression were utilized to identify risk factors associated with MHD. All persons not experiencing MHD were followed until study completion in January 2008. Results: 494 subjects (51% Black, 93% male, median CD4 count 458) were followed for 5200 py. 160 subjects developed MHD for an overall incidence of 3.1/100 py of follow up. The incidence of depression and anxiety were 2.4/100 py and 0.4/100 py, respectively. Factors associated with a diagnosis of incident MHD include receipt of a protease inhibitor (PI) based regimen (HR 2.0), non-Black ethnicity, and HIV diagnosis in the post HAART era; male gender was protective. Conclusion: In a cohort with limited confounding, incident MHD was common. Unlike prior studies, nonnucleoside reverse transcriptase inhibitor (NNRTI) use and MHD association was not observed; instead PI use was associated with MHD, perhaps due to PI enhanced mitochondrial toxicity, signaling need for further research. Given the significant burden of MHD observed in this cohort, mental health screening should be considered in the management of HIV infection.
AB - Objective(s): To define the incidence of mental health disorders (MHD) and risk factors associated with incident MHD in an HIV clinic setting with unrestricted access to care and limited confounding due to concomitant injection drug use (IDU). Design: Retrospective cohort study. Methods: Eligible subjects were HIV positive adults followed at a US military treatment facility during the calendar year 2005. Incidence rates are calculated per 100 person years (py). Cox proportional hazards regression were utilized to identify risk factors associated with MHD. All persons not experiencing MHD were followed until study completion in January 2008. Results: 494 subjects (51% Black, 93% male, median CD4 count 458) were followed for 5200 py. 160 subjects developed MHD for an overall incidence of 3.1/100 py of follow up. The incidence of depression and anxiety were 2.4/100 py and 0.4/100 py, respectively. Factors associated with a diagnosis of incident MHD include receipt of a protease inhibitor (PI) based regimen (HR 2.0), non-Black ethnicity, and HIV diagnosis in the post HAART era; male gender was protective. Conclusion: In a cohort with limited confounding, incident MHD was common. Unlike prior studies, nonnucleoside reverse transcriptase inhibitor (NNRTI) use and MHD association was not observed; instead PI use was associated with MHD, perhaps due to PI enhanced mitochondrial toxicity, signaling need for further research. Given the significant burden of MHD observed in this cohort, mental health screening should be considered in the management of HIV infection.
KW - Antiretroviral agents
KW - Anxiety
KW - Depression
KW - HIV
KW - Mental health
KW - Military
UR - http://www.scopus.com/inward/record.url?scp=84879818616&partnerID=8YFLogxK
U2 - 10.4172/2155-6113.1000149
DO - 10.4172/2155-6113.1000149
M3 - Article
AN - SCOPUS:84879818616
SN - 2155-6113
VL - 3
JO - Journal of AIDS and Clinical Research
JF - Journal of AIDS and Clinical Research
IS - 4
ER -