由内而外：急性HIV感染中肿瘤坏死因子α受体II与性相关药物使用可预测尽管接受抗逆转录病毒治疗仍会出现持续性抑郁症状。

Inside out: TNFa-RII and sexualized drug use in acute HIV predicts persistent depressive symptoms despite antiretroviral therapy.

作者信息

Chavez Jennifer V, Bolzenius Jacob, Chan Phillip, Cho Kyu, Mannarino Julie, Sacdalan Carlo, Farhadian Shelli, Trautmann Lydie, Ndhlovu Lishomwa C, Tipsuk Somporn, Crowell Trevor A, Krebs Shelly J, Slike Bonnie, Suttichom Duanghathai, Colby Donn J, Phanuphak Nittaya, Kroon Eugène, Vasan Sandhya, Sriplienchan Somchai, Spudich Serena, Paul Robert, Carrico Adam W

机构信息

Department of Environmental Health Sciences, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA.

Missouri Institute of Mental Health, University of Missouri, St. Louis, St. Louis, MO, USA.

出版信息

Brain Behav Immun Health. 2025 Jul 28;48:101079. doi: 10.1016/j.bbih.2025.101079. eCollection 2025 Oct.

DOI:10.1016/j.bbih.2025.101079

PMID:40808976

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12345309/

Abstract

OBJECTIVE

Although pathophysiologic alterations during acute HIV infection (AHI) may have long-term neuropsychiatric consequences, scant research has examined biobehavioral predictors of distinct depressive symptom trajectories from AHI through suppressive anti-retroviral therapy (ART), despite the fact that depressive symptoms have been associated with poorer adherence to ART and overall quality of life.

METHODS

This analysis utilized data from the RV254/SEARCH010 Cohort, a large, well-characterized AHI cohort in Bangkok, Thailand. Longitudinal hierarchal density-based spatial clustering with uniform manifold approximation and projection was used to examine depressive symptom trajectories from AHI through 96 weeks of suppressive ART. Logistic regressions examined the immunologic and behavioral correlates of persistently high (versus low) depressive symptom trajectories.

RESULTS

Participants (N = 502) were between the ages of 18 and 70, with a mean age of 27.7 (SD 7.4). The sample was predominantly male (98 %, n = 494). Three depressive symptom trajectories emerged: Cluster 1 (n = 257, 51 %) persistently high, Cluster 2 (n = 61, 12 %) transient, and Cluster 3 (n = 184, 37 %) persistently low. There were greater odds of persistently high (versus low) depressive symptoms for every logcopies/mL increase in plasma viral load (Odds Ratio [OR] = 1.27; 95 % Confidence Interval [CI] = 0.99-3.35) and sTNF-αRII (OR = 1.23, 95 % CI = 1.04, 1.45) at baseline. Recent amyl nitrite use also increased risk (OR = 2.39; 95 % CI = 1.17, 4.88).

CONCLUSIONS

Viral load, inflammation and substance use may be viable targets for reducing risk for depressive disorders in people with HIV, even in its earliest stages.

摘要

目的

尽管急性HIV感染（AHI）期间的病理生理改变可能会产生长期的神经精神后果，但很少有研究探讨从AHI到接受抑制性抗逆转录病毒治疗（ART）期间不同抑郁症状轨迹的生物行为预测因素，尽管抑郁症状与ART依从性较差和总体生活质量相关。

方法

本分析使用了来自RV254/SEARCH010队列的数据，这是泰国曼谷一个规模大、特征明确的AHI队列。采用基于纵向层次密度的空间聚类以及均匀流形逼近和投影方法，来研究从AHI到96周抑制性ART期间的抑郁症状轨迹。逻辑回归分析了持续高（与低）抑郁症状轨迹的免疫和行为相关性。

结果

参与者（N = 502）年龄在18至70岁之间，平均年龄为27.7岁（标准差7.4）。样本以男性为主（98%，n = 494）。出现了三种抑郁症状轨迹：第1组（n = 257，51%）持续高症状，第2组（n = 61，12%）短暂症状，第3组（n = 184，37%）持续低症状。基线时，血浆病毒载量每增加1 log拷贝/mL（比值比[OR]=1.27；95%置信区间[CI]=0.99 - 3.35）和sTNF-αRII（OR = 1.23，95% CI = 1.04，1.45），持续高（与低）抑郁症状的几率就更高。近期使用亚硝酸异戊酯也会增加风险（OR = 2.39；95% CI = 1.17，4.88）。