Depression and anxiety were low amongst virally suppressed, long-term treated HIV-infected individuals enrolled in a public sector antiretroviral program in Thailand^*

* This study was partly presented as a poster (WEPEB333) at the 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention on 19–23 July 2015 at Vancouver, British Columbia, Canada.

ABSTRACT

HIV/AIDS and anxiety/depression are interlinked. HIV-infected patients suffering from depression may be at risk for poor adherence which may contribute to HIV disease progression. Additionally, an HIV diagnosis and/or using certain antiretroviral agents may trigger symptoms of anxiety/depression. The objective of the study was to assess the prevalence and factors associated with anxiety and depression in HIV-infected patients from the Thai National HIV Treatment Program. This cross-sectional study was performed from January 2012 to December 2012 in HIV-infected out-patients, aged ≥18 years, from three HIV referral centers. Symptoms of anxiety and depression were measured using the Thai-validated Hospital Anxiety and Depression Scale (HADS). A score of ≥11 was defined as having anxiety and depression. Associated factors were assessed by multivariate logistic regression. Totally 2023 (56% males) patients were enrolled. All patients received antiretroviral therapy (ART) for a mean duration of 7.7 years. Median CD4 was 495 cells/mm³. Ninety-five percent had HIV-RNA < 50 copies/ml. Thirty-three percent were currently on efavirenz (EFV)-based ART. The prevalence of anxiety and depression were 4.8% and 3.1%, respectively. About 1.3% had both anxiety and depression. In multivariate logistic models, the female sex [OR = 1.6(95%CI 1.1–2.3), p = .01], having adherence <90% [OR = 2.2(95%CI 1.5–3.4), p < .001], fair/poor quality of life (QOL) [OR = 7.2 (95%CI 3.6–14.2), p < .001] and EFV exposure [OR = 1.6(95%CI 1.1–2.3), p = .01], were independently associated with having anxiety or depression. Our findings demonstrated that prevalence of depression and anxiety was low amongst virally suppressed, long-term antiretroviral-treated HIV-infected individuals. Some key characteristics such as the female sex, poor adherence, poor/fair QOL and EFV exposure are associated with anxiety and depression. These factors can be used to distinguish who would need a more in-depth evaluation for these psychiatric disorders.

KEYWORDS:

• Depression
• anxiety
• HIV-1 infected patients
• female
• efavarenz
• Thailand

Acknowledgements

The views expressed are those of the authors and should not be construed to represent the positions of the U.S. Army or the Department of Defense. We would like to thank all of our patients for their strong, dedicated commitment and continuous, unwavering support throughout the years, and all staff from Bamrasnaradura Institute, Sanpatong Hospital, HIV-NAT, Thai Red Cross AIDS Research Centre, and the Department of Disease Control, Ministry of Public Health, Thailand, for their invaluable work and assistance.

Disclosure statement

KR has received the Senior Research Scholar from Thailand Research Fund (TRF). And he received honoraria or consultation fees from Merck, Roche, Jensen-Cilag, Tibotec, Mylan and GPO (Governmental pharmaceutical organization, Thailand). He has also been participated in a company sponsored speaker’s bureau from Abbott, Gilead, Bristol-Myers Squibb, Merck, Roche, Jensen-Cilag, GlaxoSmithKline, and GPO (Governmental pharmaceutical organization). The rest of the authors declare no conflict of interest.

Notes

* This study was partly presented as a poster (WEPEB333) at the 8th IAS Conference on HIV Pathogenesis, Treatment and Prevention on 19–23 July 2015 at Vancouver, British Columbia, Canada.

Additional information

Funding

This study was sponsored by the Department of Disease Control, Ministry of Public Health, Thailand.