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. 2023 Oct;29(5):538-554.
doi: 10.1007/s13365-023-01145-z. Epub 2023 Aug 31.

Combined effects of loneliness and inflammation on depression in people with HIV

Mariam A Hussain  1   2   3 , C Wei-Ming Watson  4   5   6 , Erin E Morgan  5   6 , Robert K Heaton  5   6 , Scott L Letendre  5   6 , Dilip V Jeste  5   7   8 , David J Moore  5   6 , Jennifer E Iudicello  5   6
Affiliations

Combined effects of loneliness and inflammation on depression in people with HIV

Mariam A Hussain et al. J Neurovirol. 2023 Oct.

Abstract

Objective: Loneliness is prevalent in people with HIV (PWH) and associated with adverse health-related consequences, including depression. Chronic inflammation has been linked to depression in PWH, though its association with loneliness is less well established. Simultaneous examination of inflammation, loneliness and depression is needed to clarify these relationships. This study investigated the relationship between loneliness and inflammation, and the effects of loneliness and inflammation on depression in PWH.

Methods: 82 PWH who were on suppressive ART (mean age [SD] = 53.2 [9.0]) completed the UCLA Loneliness Scale-Version 3 and the Center for Epidemiologic Studies Depression Scale as part of a comprehensive evaluation. Biomarkers of systemic inflammation (CRP, IL-6, CCL2/MCP-1, sCD14) and coagulation (D-dimer) were measured in blood using commercial immunoassays.

Results: Multivariable linear regression analyses revealed that higher D-dimer, CCL2/MCP-1, and sCD14 were significant predictors of loneliness (ps < .05) while accounting for relevant covariates. Stepwise multiple linear regression models that included loneliness, biomarkers, and their interactions as predictors of depressive symptoms revealed significant main effects of loneliness and CCL2/MCP-1 levels (ps < .05), and a significant loneliness by D-dimer interaction (p < .05) whereby higher D-dimer was associated with increased depressive symptoms only at higher levels of loneliness.

Conclusions: Increased coagulation activity is associated with loneliness, and in the context of loneliness, may increase risk for depression. Increased inflammation was associated with depression suggesting potentially dissociable underlying biological processes. To the extent that these processes are modifiable, such findings could have important implications in the treatment of loneliness and depression in PWH.

Keywords: (4–6): Social determinants of health; Coagulation; D-dimer; Monocyte chemoattractant protein-1; Psychological distress.

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Conflict of interest statement

M.A.H. declares that they have no conflict of interest. C.W-M.W. declares that they have no conflict of interest. E.E.M. declares that they have no conflict of interest. R.K.H. declares that they have no conflict of interest. S.L.L. declares that they have no conflict of interest. D.V.J. declares that they have no conflict of interest. D.J.M. declares that they have no conflict of interest. J.E.I. declares that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Higher loneliness scores (UCLA-3 Total scores), in conjunction with high D-dimer values, contributed to an additive effect on depressive symptoms (CES-D Total scores) in PWH
See this image and copyright information in PMC

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