Aibibula Wusiman, Cox Joseph, Hamelin Anne-Marie, Moodie Erica E M, Anema Aranka, Klein Marina B, Brassard Paul
a Department of Epidemiology, Biostatistics and Occupational Health , McGill University , Montreal , QC , Canada.
b Public Health Department , CIUSSS du Centre-Est-de-l 'Ile-de-Montréal , Montréal , QC , Canada.
AIDS Care. 2018 May;30(5):643-649. doi: 10.1080/09540121.2018.1431385. Epub 2018 Jan 28.
Depressive symptoms are associated with poor HIV viral control and immune recovery among people living with HIV. However, no prior studies assessed this association exclusively among people co-infected with HIV-hepatitis C virus (HCV). While people with HIV only and those with HIV-HCV co-infection share many characteristics, co-infected people may become more susceptible to the effects of depressive symptoms on health outcomes. We assessed this association exclusively among people co-infected with HIV-HCV in Canada using data from the Food Security & HIV-HCV Sub-Study (FS Sub-Study) of the Canadian Co-Infection Cohort (CCC). Stabilized inverse probability weighted marginal structural model was used to account for potential time-varying confounders. A total of 725 participants were enrolled between 2012 and 2015. At baseline, 52% of participants reported depressive symptoms, 75% had undetectable HIV viral load, and median CD4 count was 466 (IQR 300-665). People experiencing depressive symptoms had 1.32 times (95% CI: 1.07, 1.63) the risk of having detectable HIV viral load, but had comparable CD4 count to people who did not experience depressive symptoms (fold change of CD4 = 0.96, 95% CI: 0.91, 1.03). Presence of depressive symptoms is a risk factor for incomplete short-term HIV viral suppression among people co-infected with HIV-HCV. Therefore, depressive symptoms screening and related counseling may improve HIV related health outcomes and reduce HIV transmission.
抑郁症状与感染艾滋病毒者的艾滋病毒病毒控制不佳和免疫恢复不良有关。然而，以前没有研究专门评估艾滋病毒与丙型肝炎病毒（HCV）合并感染者之间的这种关联。虽然仅感染艾滋病毒的人和艾滋病毒与丙型肝炎病毒合并感染的人有许多共同特征，但合并感染者可能更容易受到抑郁症状对健康结果的影响。我们利用加拿大合并感染队列（CCC）的粮食安全与艾滋病毒-丙型肝炎病毒子研究（FS子研究）的数据，专门评估了加拿大艾滋病毒与丙型肝炎病毒合并感染者之间的这种关联。使用稳定的逆概率加权边际结构模型来考虑潜在的随时间变化的混杂因素。2012年至2015年期间共招募了725名参与者。在基线时，52%的参与者报告有抑郁症状，75%的人艾滋病毒病毒载量检测不到，CD4细胞计数中位数为466（四分位间距300-665）。有抑郁症状的人艾滋病毒病毒载量可检测到的风险是没有抑郁症状者的1.32倍（95%置信区间：1.07，1.63），但与没有抑郁症状的人相比，CD4细胞计数相当（CD4的变化倍数=0.96，95%置信区间：0.91，1.03）。抑郁症状的存在是艾滋病毒与丙型肝炎病毒合并感染者短期艾滋病毒病毒抑制不完全的一个危险因素。因此，抑郁症状筛查和相关咨询可能会改善与艾滋病毒相关的健康结果并减少艾滋病毒传播。
