HIV Plus Depression Means Higher Mortality Risk

NOVEMBER 21, 2016
Gale Scott
Depression is associated with cardiac risk factors in HIV-positive people. But does depression make these patients more likely to die?

Reporting at IDWeek 2016 in New Orleans, LA on Oct. 29 Samir Gupta, MD, MS, of Indiana University School of Medicine in Indianapolis, IN and colleagues there and at other institutions found that it often does.

Using data from the Veterans Aging Cohort Study (VACS) they took ICD-9 codes for major depressive disorder (MDD) and for HIV and to look for the risk for all-cause mortality. The team also used a Patient Health Questionnaire to sort out these depressed HIV patients.

They controlled for demographics, obesity, traditional cardio vascular risk factors, substance use, hepatitis C co-infection, kidney disease, hemoglobin, and use of statins.

The results showed that after a median follow-up period of 10 years, the hazard ratio for people who had both HIV and depression was greater than those without depression.

According to the study, In adjusted Cox models, the hazard ratios (95% CI; p-value) for mortality in the virtual cohort  for the HIV-/MDD+, HIV+/MDD-, and HIV+/MDD+ groups compared to the HIV-/MDD- group were, respectively, 1.07 (1.03, 1.12; p=0.001), 1.49 (1.45, 1.54; p<0.001), and 1.57 (1.50, 1.65; p<0.001). The hazard ratios (95% CI; p-value) for mortality in the biomarker cohort for the HIV-/Patient Health Questionnaire (PHQ) score 9 ≥10, HIV+/PHQ-9 <10, and HIV+/PHQ-9 ≥10 groups compared to the HIV-/PHQ-9 <10 group were, respectively, 1.36 (0.99, 1.85; p=0.06), 1.33 (1.04, 1.70; p=0.021), and 1.51 (1.12, 2.03; p=0.007).

The team concluded “In separate analyses using both diagnostic codes and a more sensitive instrument for identifying depression, we found that depression in combination with HIV infection was strongly associated with increased all-cause mortality in US Veterans.”

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