Depression associated with failure to suppress viral load

Issue: August 2014

New data presented at AIDS 2014 suggest that undiagnosed and untreated depression was associated with incomplete viral load suppression among those living with HIV — even those who were retained in care.

Researchers from the AIDS Institute at the New York State Department of Health and Columbia University collected data on 9,943 patients receiving HIV treatment at 186 ambulatory care clinics. They obtained data on viral load values and the results from screening tests for depression, anxiety, cognitive function impairment and posttraumatic stress disorder. Multivariate analyses were used to assess the relationship between mental illness and viral load suppression, controlling for age and substance use.

The researchers found that failure to achieve viral suppression was significantly associated with depression (P<.005), anxiety (P<.05), cognitive impairment (P<.005) and PTSD (P<.05), although only depression showed an independent association with the failure to suppress in multivariate analysis (OR=0.735; 95% CI, 0.638-0.847). The relationship between depression and incomplete viral load suppression was the most pronounced in heterosexual men (OR=0.596; 95% CI, 0.424-0.837), and also in women (OR=0.799; 95% CI, 0.643-0.995), but it was not significant for other patient groups.

Additionally, the researchers found that treatment for depression was significantly associated with the achievement of viral suppression (OR=1.48; 95% CI, 1.15-1.89)

“Improved diagnosis and treatment of depression and better coordination of care are vital for achieving better rates of [viral load suppression] to achieve the goals of improving clinical outcomes and reducing community transmission of HIV,” the researchers wrote in the study abstract.

For more information:

Peters J. Abstract MOPE121. Presented at: International AIDS Conference; July 20-25, 2014; Melbourne, Australia.

Disclosure: The researchers report no relevant financial disclosures.