Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
AIDS Behav. 2019 Mar;23(3):564-571. doi: 10.1007/s10461-018-2273-4.
This study aims to characterize associations between depression symptom severity and HIV infection, both prior to and in years after ART initiation, among older adults. The Ugandan Non-Communicable Diseases & Aging Cohort Study (UGANDAC) is a study of 154 PLWH on ART and 142 community-based, HIV-negative controls. The Hopkins Checklist (HSCL), a 15-item depression scale, was used to screen for depression. We estimate differences in depressive symptoms by HIV and ART status and use multivariable log binomial regression to quantify differences in probable depression between PLWH on ART. HIV-infected and HIV-uninfected participants had a similar age (mean 52.0 vs. 51.9, p = 0.854) and sex distribution (47.4 vs. 47.9% female, p = 0.934). PLWH on ART had lower depression symptom severity than HIV-uninfected controls (mean score: 1.50 vs. 1.60, p = 0.006) and a lower prevalence of probable depression (21.4 vs. 33.8%, p = 0.017). Among 102 PLWH with pre-ART depression screening scores available, their mean depression symptom severity was similar to HIV-uninfected participants (mean 1.56 vs. 1.60, p = 0.512). In adjusted models, PLWH on ART had a lower prevalence of probable depression than HIV-negative controls [adjusted prevalence ratio: 0.68 (95% CI 0.47-0.99)]. In an observational cohort of PLWH over 40 on long-term ART and matched, community-based HIV-uninfected controls in rural Uganda, we found a lower prevalence of self-reported depression among aging PLWH on ART.
本研究旨在描述在开始抗逆转录病毒治疗（ART）之前和之后数年中，抑郁症状严重程度与 HIV 感染之间的关联，对象为老年人。乌干达非传染性疾病与老龄化队列研究（UGANDAC）是一项针对 154 名接受 ART 的 PLWH 和 142 名基于社区的 HIV 阴性对照者的研究。采用 15 项汉密尔顿抑郁量表（HSCL）筛查抑郁。我们根据 HIV 和 ART 状况估计抑郁症状的差异，并采用多变量对数二项式回归量化接受 ART 的 PLWH 中可能存在的抑郁差异。HIV 感染者和 HIV 未感染者的年龄（平均 52.0 岁 vs. 51.9 岁，p=0.854）和性别分布（47.4% vs. 47.9%为女性，p=0.934）相似。与 HIV 未感染者相比，接受 ART 的 PLWH 的抑郁症状严重程度较低（平均评分：1.50 分 vs. 1.60 分，p=0.006），且可能患有抑郁的比例较低（21.4% vs. 33.8%，p=0.017）。在 102 名有 ART 前抑郁筛查评分的 PLWH 中，他们的抑郁症状严重程度与 HIV 未感染者相似（平均 1.56 分 vs. 1.60 分，p=0.512）。在调整模型中，与 HIV 阴性对照组相比，接受 ART 的 PLWH 更可能患有抑郁[调整后患病比值比：0.68（95%可信区间：0.47-0.99）]。在乌干达农村一项针对长期接受 ART 的 40 岁以上 PLWH 和匹配的基于社区的 HIV 未感染者的观察性队列研究中，我们发现接受 ART 的老年 PLWH 中自我报告抑郁的比例较低。
