Group Health study shows depression worsens HIV treatment

The study looked at 3,359 HIV-infected patients from seven Kaiser Permanente regions nationwide and Group Health in 2000 to 2003 to measure the effects of depression -- with and without selective serotonin reuptake inhibitors (SSRI) use -- on adherence and changes in viral and immunologic control in patients starting a new highly active antiretroviral therapy (HAART) regimen.

The researchers studied the patients’ HAART adherence, viral loads, and changes in CD4 T-cell counts over a 12-month period. The study found that depressed patients -- 42 percent of the patient group -- had a lower adherence rate and worse viral therapy response compared to non-depressed patients. But depressed patients who were prescribed SSRI medication and adhered to it had the same outcomes as non-depressed patients.

“The take-home point of this study is that depression carries a worse prognosis for HAART in HIV patients. However, we also found that SSRIs can reverse this and improve outcomes for HIV-depressed patients,” said Michael A. Horberg, MD, MAS, FACP, Director of HIV/AIDS for Kaiser Permanente and the lead author on the study. “HIV and depression often go hand in hand. If you are HIV-infected, you should be screened regularly for depression, and if you are depressed and you are going to go on HAART, it’s very worthwhile to treat your depression.”-Kaiser Permanente Division of Research