Department of Neurology, Yale University School of Medicine, 300 George Street, Room 8300c, New Haven, CT, USA,
AIDS Behav. 2014 Jun;18(6):1124-32. doi: 10.1007/s10461-013-0688-5.
Though depression is known to frequently afflict those with chronic HIV, mood during the early course of HIV is not well characterized. In a prospective study we assessed mood during primary HIV infection [primary HIV infection (PHI), <1 year duration], its association with neuropsychological performance and markers of neurological disease, and its longitudinal course including effects of antiretroviral therapy (ART). The Beck Depression Inventory (BDI) and Profile of Mood States (POMS) subscales were longitudinally administered prior to and after ART in PHI subjects. This evaluation of mood was done concurrently with blood, cerebrospinal fluid (CSF) and neuropsychological [total z and global deficit score (GDS)] evaluation at each visit. Analysis employed Spearman's rho, logistic regression, and linear mixed models. 47.7 % of the 65 men recruited at a median 3.5 months HIV duration met BDI criteria for clinical depression at baseline, classified as 'mild' (n = 11), 'moderate' (n = 11), or 'severe' (n = 9). Drug, alcohol, and depression history did not associate with BDI score. Proportional somatic-performance scores were worse than cognitive-affective scores (p = .0045). Vigor subscore of POMS was reduced compared to norms and correlated with total z (r = 0.33, p = 0.013) and GDS (r = -0.32, p = 0.016). BDI and POMS correlated with one another (r = 0.85, p < .0001), but not with CSF or plasma HIV RNA, WBC, albumin ratio or neopterin. Improvement was not observed in BDI and POMS over 330 total follow-up visits, even after initiation of ART. Depression was prevalent during PHI in our subjects, associated with abnormal somatic-performance and vigor scores. Neither neuropsychological performance nor disease biomarkers correlated with depressed mood. Mood indices did not improve over time in the presence of ART.
虽然抑郁症经常困扰慢性 HIV 感染者，但 HIV 早期的情绪状态尚未得到充分描述。在一项前瞻性研究中，我们评估了原发性 HIV 感染期间的情绪[原发性 HIV 感染（PHI），<1 年]、其与神经心理学表现和神经疾病标志物的关系，以及包括抗逆转录病毒治疗（ART）影响在内的纵向病程。贝克抑郁量表（BDI）和心境状态量表（POMS）子量表在 PHI 受试者接受 ART 前后进行了纵向评估。每次就诊时，同时进行血液、脑脊液（CSF）和神经心理学[总 z 和整体缺陷评分（GDS）]评估，以评估情绪。采用 Spearman's rho、逻辑回归和线性混合模型进行分析。在中位 HIV 病程 3.5 个月时招募的 65 名男性中，有 47.7%的人符合 BDI 临床抑郁症标准，分为“轻度”（n=11）、“中度”（n=11）或“重度”（n=9）。药物、酒精和抑郁史与 BDI 评分无关。比例躯体表现评分比认知情感评分差（p=0.0045）。与常模相比，POMS 的活力子量表降低，与总 z（r=0.33，p=0.013）和 GDS（r=-0.32，p=0.016）相关。BDI 和 POMS 彼此相关（r=0.85，p<0.0001），但与 CSF 或血浆 HIV RNA、WBC、白蛋白比值或新蝶呤无关。即使在开始 ART 后，BDI 和 POMS 在 330 次总随访期间也未观察到改善。在我们的研究对象中，PHI 期间抑郁较为普遍，与躯体表现和活力评分异常有关。神经心理学表现和疾病生物标志物均与抑郁情绪无关。在 ART 存在的情况下，情绪指标并未随时间改善。
