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HIV/HCV合并感染中情绪困扰的患病率及其相关因素

Prevalence and correlates of emotional distress in HIV/HCV coinfection.

作者信息

Pereira Marco, Fialho Renata, Canavarro Maria Cristina

机构信息

a Faculty of Psychology and Educational Sciences , University of Coimbra , Coimbra , Portugal.

出版信息

AIDS Care. 2014;26 Suppl 1:S56-64. doi: 10.1080/09540121.2014.906549. Epub 2014 Apr 10.

DOI:10.1080/09540121.2014.906549
PMID:24720733
Abstract

The mental health needs of patients who are coinfected with hepatitis C virus (HCV) and human immunodeficiency virus (HIV) are increasingly addressed in medical settings. This study aimed at examining the prevalence and severity of emotional distress in a sample of HIV/HCV coinfected and HIV mono-infected patients and to examine their sociodemographic, clinical, and psychosocial correlates. The Brief Symptom Inventory and the quality of life instrument WHOQOL-HIV-Bref were administered to a sample of 248 HIV/HCV coinfected patients and 482 HIV mono-infected patients. Thirty-nine (15.9%) HIV/HCV coinfected patients and 55 (11.6%) HIV mono-infected patients reported a T-score ≥ 63 for global severity index (GSI), indicative of a need for further psychological evaluation. Coinfected patients reported significantly higher scores on eight of nine dimensions of psychopathology. The larger differences were found on somatization, hostility, paranoid ideation, anxiety, and the GSI. Among HIV/HCV patients, non-highly active antiretroviral therapy (β = -0.19, p < 0.01) and lower scores for independence (β = -0.24, p < 0.01) and spiritual (β = -0.31, p < 0.001) dimensions were significantly associated with higher emotional distress and accounted for 47.2% of the total variance. Among HIV mono-infected patients, being diagnosed for a longer time (β = 0.12, p < 0.05) and having lower scores on physical (β = -0.23, p < 0.001), social relationships (β = -0.11, p < 0.05), environmental (β = -0.17, p < 0.01), and spiritual (β = -0.21, p < 0.001) dimensions explained 39.4% of the variance of emotional distress. The findings suggest that coinfection with HCV may have an adverse effect on mental health and underscore the interplay of sociodemographic, clinical, and psychosocial variables on emotional distress. Additionally, these data reinforce the need for tailored interventions to improve the overall well-being of both HIV and HIV/HCV patients.

摘要

丙型肝炎病毒(HCV)和人类免疫缺陷病毒(HIV)合并感染患者的心理健康需求在医疗环境中越来越受到关注。本研究旨在调查HIV/HCV合并感染患者和HIV单感染患者样本中情绪困扰的患病率和严重程度,并研究其社会人口统计学、临床和心理社会相关因素。对248例HIV/HCV合并感染患者和482例HIV单感染患者样本进行了简明症状量表和生活质量工具WHOQOL-HIV-Bref评估。39例(15.9%)HIV/HCV合并感染患者和55例(11.6%)HIV单感染患者报告全球严重程度指数(GSI)的T分数≥63,表明需要进一步进行心理评估。合并感染患者在精神病理学的九个维度中的八个维度上报告的分数显著更高。在躯体化、敌意、偏执观念、焦虑和GSI方面发现了更大的差异。在HIV/HCV患者中,非高效抗逆转录病毒治疗(β = -0.19,p < 0.01)以及独立性(β = -0.24,p < 0.01)和精神维度(β = -0.31,p < 0.001)得分较低与更高的情绪困扰显著相关,占总方差的47.2%。在HIV单感染患者中,诊断时间较长(β = 0.12,p < 0.05)以及在生理(β = -0.23,p < 0.001)、社会关系(β = -0.11,p < 0.05)、环境(β = -0.17,p < 0.01)和精神维度(β = -0.21,p < 0.001)得分较低解释了情绪困扰方差的39.4%。研究结果表明,HCV合并感染可能对心理健康产生不利影响,并强调了社会人口统计学、临床和心理社会变量在情绪困扰方面的相互作用。此外,这些数据强化了需要采取针对性干预措施以改善HIV患者和HIV/HCV患者整体幸福感的必要性。

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