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. 2016 Mar 22;6(1):128-35.
doi: 10.5498/wjp.v6.i1.128.

Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

Sasraku Amanor-Boadu  1 , MariaMananita S Hipolito  1 , Narayan Rai  1 , Charlee K McLean  1 , Kyla Flanagan  1 , Flora T Hamilton  1 , Valerie Oji  1 , Sharon F Lambert  1 , Huynh Nhu Le  1 , Suad Kapetanovic  1 , Evaristus A Nwulia  1
Affiliations

Poor CD4 count is a predictor of untreated depression in human immunodeficiency virus-positive African-Americans

Sasraku Amanor-Boadu et al. World J Psychiatry. .

Abstract

Aim: To determine if efforts to improve antiretroviral therapy (ART) adherence minimizes the negative impact of depression on human immunodeficiency virus (HIV) outcomes.

Methods: A cross-sectional study of a clinic-based cohort of 158 HIV seropositive (HIV+) African Americans screened for major depressive disorder (MDD) in 2012. CD4 T lymphocyte (CD4+) counts were obtained from these individuals. Self-report on adherence to ART was determined from questionnaire administered during clinic visits. The primary outcome measure was conditional odds of having a poorer CD4+ count (< 350 cells/mm(3)). Association between CD4+ count and antidepressant-treated or untreated MDD subjects was examined controlling for self-reported adherence and other potential confounders.

Results: Out of 147 individuals with available CD4+ T lymphocyte data, 31% hadCD4+ count < 350 cells/mm(3) and 28% reported poor ART adherence. As expected the group with > 350 cells/mm(3) CD4+ T lymphocyte endorsed significantly greater ART adherence compared to the group with < 350 cells/mm(3) CD4+ T lymphocyte count (P < 0.004). Prevalence of MDD was 39.5% and 66% of individuals with MDD took antidepressants. Poor CD4+ T lymphocyte count was associated with poor ART adherence and MDD. Adjusting for ART adherence, age, sex and education, which were potential confounders, the association between MDD and poor CD4+ T lymphocyte remained significant only in the untreated MDD group.

Conclusion: Therefore, CD4+ count could be a clinical marker of untreated depression in HIV+. Also, mental health care may be relevant to primary care of HIV+ patients.

Keywords: African Americans; Antiretroviral Therapy; CD4 T lymphocyte count; Depression; Human immunodeficiency virus positive.

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