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Longitudinal Characterization of Depression and Mood States Beginning in Primary HIV Infection

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Abstract

Though depression is known to frequently afflict those with chronic HIV, mood during the early course of HIV is not well characterized. In a prospective study we assessed mood during primary HIV infection [primary HIV infection (PHI), <1 year duration], its association with neuropsychological performance and markers of neurological disease, and its longitudinal course including effects of antiretroviral therapy (ART). The Beck Depression Inventory (BDI) and Profile of Mood States (POMS) subscales were longitudinally administered prior to and after ART in PHI subjects. This evaluation of mood was done concurrently with blood, cerebrospinal fluid (CSF) and neuropsychological [total z and global deficit score (GDS)] evaluation at each visit. Analysis employed Spearman’s rho, logistic regression, and linear mixed models. 47.7 % of the 65 men recruited at a median 3.5 months HIV duration met BDI criteria for clinical depression at baseline, classified as ‘mild’ (n = 11), ‘moderate’ (n = 11), or ‘severe’ (n = 9). Drug, alcohol, and depression history did not associate with BDI score. Proportional somatic-performance scores were worse than cognitive-affective scores (p = .0045). Vigor subscore of POMS was reduced compared to norms and correlated with total z (r = 0.33, p = 0.013) and GDS (r = −0.32, p = 0.016). BDI and POMS correlated with one another (r = 0.85, p < .0001), but not with CSF or plasma HIV RNA, WBC, albumin ratio or neopterin. Improvement was not observed in BDI and POMS over 330 total follow-up visits, even after initiation of ART. Depression was prevalent during PHI in our subjects, associated with abnormal somatic-performance and vigor scores. Neither neuropsychological performance nor disease biomarkers correlated with depressed mood. Mood indices did not improve over time in the presence of ART.

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Acknowledgments

We sincerely thank the participants who volunteered for these studies. We also thank the San Francisco General Hospital (SFGH)/University of California–San Francisco (UCSF) Clinical Research Center, staff at the ARI-UCSF Laboratory of Clinical Virology, and staff at UCSF Options and Magnet/San Francisco AIDS Foundation for their invaluable help. This study was funded by the following Grants: National Institutes of Health (Grants R01 MH081772, K23 MH074466, P30 AI027763, P01 AI071713 and M01 RR0008336)), Yale Medical School Summer Research Fellowship.

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Authors and Affiliations

  1. Department of Neurology, Yale University School of Medicine, 300 George Street, Room 8300c, New Haven, CT, USA

    Jessica A. Gold & Serena Spudich

  2. Department of Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Marie Grill, Julia Peterson, Evelyn Lee & Richard W. Price

  3. Department of Medicine, School of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Christopher Pilcher & Frederick M. Hecht

  4. Division of Biological Chemistry, Innsbruck Medical University, Innsbruck, Austria

    Dietmar Fuchs

  5. Department of Biostatistics, School of Public Health, Indiana University, Indianapolis, IN, USA

    Constantin T. Yiannoutsos

  6. Department of Neurology, University of North Carolina School of Medicine, Chapel Hill, NC, USA

    Kevin Robertson

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  1. Jessica A. Gold
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  2. Marie Grill
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  11. Serena Spudich
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Correspondence to Jessica A. Gold.

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Gold, J.A., Grill, M., Peterson, J. et al. Longitudinal Characterization of Depression and Mood States Beginning in Primary HIV Infection. AIDS Behav 18, 1124–1132 (2014). https://doi.org/10.1007/s10461-013-0688-5

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  • DOI: https://doi.org/10.1007/s10461-013-0688-5

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