The Double Burdens of Mental Health Among AIDS Patients With Fully Successful Immune Restoration: A Cross-Sectional Study of Anxiety and Depression in China

The prevalence and determinants of social anxiety disorder among people living with HIV/AIDS in Southwestern Ethiopia: a cross-sectional study

Background

Social anxiety disorder imposes impacts of functional disability, poor educational achievement, loss of work productivity, social impairment, greater financial dependency, and impairment in quality of life. Therefore, the aim of this study was to assess the prevalence and identify determinants of social anxiety disorder among people living with HIV/AIDS.

Methods

A cross-sectional study was conducted from 1 to 30 May 2022 among 354 people living with HIV using a simple random sampling technique. The Social Phobia Inventory (SPIN) Scale was used to assess the presence of social anxiety disorder. Data were gathered using chart review tools and a structured questionnaire, which was administered by a pretested face-to-face interviewer. SPSS version 25 was used to analyse the data once they were imported into EpiData Manager version 4.6. Binary and multivariable logistic regressions were performed. After calculating odds ratios with a 95% confidence interval (CI), statistical significance was established at p < 0.05.

Results

A total of 336 respondents participated in the study, resulting in a response rate of 94.91%. The magnitude of social anxiety disorder was 32.44% (95% CI: 27.4, 37.2). Being female [adjusted odds ratio (AOR) = 3.55, 95% CI: 1.61, 7.84], having a stage III/IV HIV/AIDS status (AOR = 3.17, 95% CI: 1.10, 9.13), being alcohol dependent (AOR = 2.81, 95% CI: 1.45, 5.44), and having perceived stigma (AOR = 5.62, 95% CI: 2.95, 10.72) were predictors of social anxiety disorder.

Conclusion

In this study, approximately one-third of people living with HIV/AIDS had social anxiety disorder. Being female, having a stage III/IV HIV/AIDS status, being alcohol dependent, and having perceived stigma were predictors of social anxiety disorder. Therefore, training for health care providers on the screening, counselling, and management of social anxiety disorder is important.

Factors Associated With Symptoms of Anxiety and Depression in People Living With HIV in Northeast Brazil

BACKGROUND

The diagnosis of HIV infection can cause mental disorders or exacerbate existing symptoms because of the stigma, psychological stress, and need for the self-management of the illness. The aim of this study was to determine the prevalence of anxiety and depression symptoms in people with HIV and to identify the associated factors.

METHODS

This is a cross-sectional study. A sample of 385 people living with HIV (PLWH) was interviewed using the Sociodemographic, Epidemiological, and Clinical Form; the Beck Anxiety Inventory; the Beck Depression Inventory; and Pittsburgh Sleep Quality Index. Univariate and multivariate logistic regression analysis were performed. The odds ratio and 95% confidence interval were calculated.

RESULTS

The prevalence of anxiety was 27.1% and depression was 39.8%. Being female (P = 0.0227), antiretroviral therapy (ART) for 8 years or less (P = 0.0042), and having depression (P < 0.0001) were associated with the occurrence of anxiety. Having a detectable viral load (P = 0.0476), not exercising regularly (P = 0.0070), and having sleep disorders (P = 0.0001) and anxiety (P < 0.0001) were associated with depression. Retired and on leave or sick pay were, respectively, 2.67 and 3.90 times more likely to have depression than those who were employed.

CONCLUSIONS

A considerable percentage of PLWH have anxiety and depression symptoms. Being female, less than 8 years of ART, and depression are associated with anxiety, while detectable viral load, not practicing physical exercise, having sleep disorders, anxiety, and being retired or on leave or sick pay are associated with depression. The study showed important data for health interventions by members of the multidisciplinary team for PLWH.

Effects of online exercise intervention on physical and mental conditions in young adults with chronic neck pain

This study aimed to compare the efficacy of online exercise therapy with conventional exercise therapy for young adults with chronic neck pain. A randomized clinical trial recruiting 35 university students with self-reported chronic neck pain was conducted. The experimental group receiving 6-week online exercise therapy and active control group receiving the same face-to-face conventional exercise therapy. Visual analogue scale (VAS) for pain, Neck Disability Index (NDI), Work Limitations Questionnaire (WLQ), Hospital Anxiety and Depression Scale (HADS) and its subscales were evaluated. Both groups had improvements in VAS, NDI, HADS and WLQ scores from baseline to 6 weeks. All comparisons of changes in outcome variables between groups were not statistically significant. For young adults with chronic neck pain, both the online and conventional exercise interventions could improve their pain level, neck disability, anxiety state, and work efficiency. The online exercise intervention appeared feasible as an alternative treatment option for them.

Risk of Depression in People With Human Immunodeficiency Virus: A Nationwide Population-based Matched Cohort Study

BACKGROUND

Human immunodeficiency virus (HIV) infection is associated with depression. However, previous studies have not addressed familial factors.

METHODS

Nationwide, population-based, matched cohort study of people with HIV (PWH) in Denmark between 1995 and 2021 who were matched on sex and date of birth with a comparison cohort randomly selected from the Danish population. Family-related factors were examined by inclusion of siblings of those in the cohorts. We calculated hazard ratios (HRs) for depression, receipt of antidepressants, electroconvulsive therapy (ECT), and suicide, as well as the yearly proportions of study cohorts with psychiatric hospital contact due to depression and receipt of antidepressants from 10 years before to 10 years after study inclusion.

RESULTS

We included 5943 PWH and 59 430 comparison cohort members. Median age was 38 years, and 25% were women. We observed an increased risk of depression, receipt of antidepressants, ECT, and suicide among PWH in the 2 first years of observation (HR, 3.3; 95% confidence interval [CI]: 2.5-4.4), HR, 3.0 (95% CI: 2.7-3.4), HR, 2.8 (95% CI: .9-8.6), and HR, 10.7 (95% CI: 5.2-22.2), thereafter the risk subsided but remained increased. The proportions of PWH with psychiatric hospital contact due to depression and receipt of antidepressants were increased prior to and especially after HIV diagnosis. Risk of all outcomes was substantially lower among siblings of PWH than among PWH (HR for receipt of antidepressants, 1.1; 95% CI: 1.0-1.2).

CONCLUSIONS

PWH have an increased risk of depression. Family-related factors are unlikely to explain this risk.

Relationships between spirituality and mental stress in people living with HIV in China: A cross-sectional study

There are limited reports on the relationship between spirituality and mental stress in PLWH in China, who may be subject to anti-religious pressures from the government. In this study, we aimed to understand whether spirituality influences Chinese PLWH's mental stress and, if so, at what level. We recruited 200 PLWHs from Beijing's Ditan Hospital to complete a cross-sectional survey inquiring about their practice of spirituality as well as their level of mental stress. The study found that PLWH who presented with a mid-level of spirituality have the highest mental stress when compared to those who have a low level of spiritual beliefs or a high level of spiritual beliefs. This study points to the utility of healthcare providers taking PLWH's potential spirituality into consideration, perhaps in particular for those with a moderate level of spirituality, in order to provide the most comprehensive care possible.

Anxiety, depression, and sleep disturbances among people on long-term efavirenz-based treatment for HIV: a cross-sectional study in Beijing, China

BACKGROUND

Efavirenz (EFV)-induced neuropsychiatric toxicity bothers people living with HIV (PLHIV). Neuropsychiatric adverse effects of EFV may differ by length of time on EFV-based antiretroviral treatment (ART).

METHODS

A cross-sectional, single-center study was conducted at Beijing Ditan Hospital in China from June-August 2020 among ART-experienced PLHIV who were on long-term EFV-based ART. 424 eligible virological suppressed participants were enrolled and divided into four groups according to time on EFV-based ART: group A (0.5 ≤ ART < 2 year), B (2 ≤ ART < 4 year), C (4 ≤ ART < 6 year), and D (ART ≥ 6 year). The questionnaires about 12-item Short Form Health Survey (SF-12), Hospital Anxiety and Depression Scale (HADS) and Pittsburgh Sleep Quality Index (PSQI) were administered to assess neuropsychiatric adverse events of EFV among different groups.

RESULTS

Overall mental component summary scores (MCS) of SF-12 in PLHIV was 50.2, which was lower than general population. Overall prevalence of anxiety, depression and sleep disturbances was 15.6%, 15.3% and 58%, respectively. Prevalence of anxiety, depression and sleep disturbances did not vary significantly between the time-on-ART groups. Anxiety, depression, sleep disturbances had no correlation with time on EFV-based ART or CD4⁺ T cells counts.

CONCLUSIONS

In ART-experienced PLHIV in China, neuropsychiatric adverse events exist persistently and prevalence do not significantly change with prolonged time on EFV-based ART. The prevalence of sleep disturbances was high, suggesting that clinicians should pay more attention to long-standing psychiatric health to perform early and effective interventions.

Trends in suicide mortality among people with HIV after diagnosis during 2012-18: a retrospective, national cohort study in China

BACKGROUND

Little is known about suicide mortality among people with HIV in low-income and middle-income countries. This study aimed to assess suicide mortality and its temporal change among people with HIV after diagnosis, then describe potential risk factors.

METHODS

This nationwide, population-based cohort study used data from the China Information System for Disease Control and Prevention (CISDCP), which continually enrolled people diagnosed with HIV in mainland China. We included all people with HIV diagnosed between Jan 1, 2012, and Dec 31, 2018, who were aged 15 years or older at diagnosis. Follow-up started from the date of HIV diagnosis to the date of death, date of last follow-up visit, or Dec 31, 2018, whichever came first. Crude suicide mortality was calculated as the number of suicide deaths divided by person-years at risk in 2012-18 and compared by time after HIV diagnosis. Standardised mortality ratios (SMRs) were used to compare the relative risk of suicide deaths in people with HIV with the general population. We compared the trends of suicide mortality across three diagnosis year groups (2012-13, 2014-15, and 2016-18) using cumulative incidence curve of suicide. Competing-risk models were used to explore the potential risk factors of suicide.

FINDINGS

770 656 people diagnosed with HIV were included in the CISDCP database, 763 287 of whom were aged 15 years or older at diagnosis and had follow-up information available. During follow-up, 2825 (2·0%) of 144 729 all-cause deaths were due to suicide, with a mortality of 142·8 deaths by suicide per 100 000 person-years (95% CI 137·7-148·2). People with HIV were at an increased risk of suicide compared with the general population (SMR 20·9 [95% CI 20·2-21·7]). The greatest risk was during the first 3 months after diagnosis (SMR 98·1 [93·1-103·4]), which then decreased but was still elevated after the first year (SMR 9·2 [8·5-9·8]). Late diagnosis and never on antiretroviral therapy were independent risk factors for suicide.

INTERPRETATION

Suicide mortality decreased during the study period, which coincided with improvement in access to care and treatment coverage. This study suggests the importance of targeted suicide prevention for people with HIV throughout the course of diagnosis and that the focus of efforts should be concentrated on the first 3 months after diagnosis. Our findings highlight the urgent need to integrate suicide screening and prevention in HIV care.

FUNDING

Young Scholar Scientific Research Foundation of National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention.

TRANSLATION

For the Chinese translation of the abstract see Supplementary Materials section.

Prevalence of Sleep Disorders and Associated Factors in People Living With HIV in the Ceará, Brazil: A Cross-sectional Study

ABSTRACT

The aim of this study was to determine the prevalence of sleep disorders and associated factors in people living with HIV (PLWH). This was a cross-sectional study with a sample of 385 participants followed-up on an outpatient basis in Fortaleza, Ceará, Brazil. Interviews were conducted using the Sociodemographic, Epidemiological and Clinical Form for PLWH and the Pittsburgh Sleep Quality Index. Descriptive statistics and univariate and multivariate logistic regression analysis were performed, and the odds ratio (OR) and 95% confidence interval (95% CI) were calculated, considering p < .05 as statistically significant. The prevalence of sleep disorders was 43.38%. Having children (p = .0054; OR = 1.91; 95% CI = 1.21-3.01), less than 8 years of education (p = .0013; OR = 2.11; 95% CI = 1.34-3.34), and not engaging in regular physical exercise (p = .0001; OR = 2.61; 95% CI = 1.61-4.23) were factors associated with the occurrence of sleep disorders. It was concluded that almost half of the sample had sleep disorders, especially those with children, low level education, and sedentary habits. These data point to the need for increased guidance on sleep hygiene, in addition to the practice of regular physical exercise for this population.

The worldwide prevalence of anxiety in acquired immune deficiency syndrome patients: A systematic review and meta-analysis

Background: Anxiety affects social, economic, and physical aspects of daily life in patients with AIDS. Therefore, it is necessary to take preventive measures and design plans to maintain their general health. The present study was the first comprehensive systematic literature review research that examined the worldwide prevalence rate of anxiety in patients with AIDS.

Methods: We searched for papers published in the English language in the major databases including Embase, PubMed, Web of Science, Scopus, Cochrane, and Google Scholar from 2000 to October 2018. There were 40 studies which found to be eligible. These studies were independently evaluated and the collected data were entered in a data extraction form, which was then analyzed by two authors and a third author if necessary. Der Simonian-Laird model was used to estimate the prevalence rate on a Forest plot at the interval confidence of 95%.

Results: The total sample size was 24111, and the total number of people with anxiety was 5546. The results based on the random-effects model showed that the rate of anxiety prevalence in the patients was 25% (CI: 95%, 21% -30%) with heterogeneity of 97.9% and a significance level of p<0.001. The South America continent with a prevalence of 38% (95% CI, 34%-42%) had the highest anxiety prevalence rates and Africa with 19% (95% CI, 12% -29%) had the lowest anxiety prevalence rates.

Conclusion: Based on findings, the prevalence of anxiety in developed countries was partially higher than in underdeveloped countries and the obtained mean in the present study. It can be a significant point for policymakers. Therefore, WHO and the world community should have special plans for these countries.

Factors associated with external HIV-related stigma and psychological distress among people living with HIV in South Africa

BACKGROUND

HIV-related stigma and psychological distress among people living with HIV (PLHIV) pose a public health challenge in most African countries. This study aims to investigate the association between HIV-related stigmatizing attitudes and psychological distress amongst PLHIV in South Africa using the 2012 nationally representative population-based household survey.

METHODS

The data used in the analysis were collected using a multi-stage stratified cluster sampling design. Bivariate and multivariate logistic regression models were used to identify factors associated with stigma among PLHIV with psychological distress. A total of 2521 HIV positive individuals that responded to the question on psychological distress, 34.3% had psychological distress and 37.9% experienced high levels of HIV related stigmatizing attitudes. Stigmatizing attitudes among PLHIV with psychological distress were significantly less likely among those with secondary level education [aOR = 0.67 (95% CI: 0.44-1.01), p = 0.050], those with correct knowledge about HIV and rejection of myths about HIV [aOR = 0.58 (95% CI: 0.38-0.89), p = 0.013], and those who ever tested for HIV [aOR = 0.65 (95% CI: 0.42-1.01), p = 0.054].

CONCLUSION

The findings suggest a need to reinvigorate stigma-reduction interventions in the national HIV response with emphasis on HIV awareness and education campaigns. In addition, HIV testing services should be reinforced through communication strategies targeted against HIV stigmatization, discrimination and fear. There is also a need to continuously engage PLHIV in programs through counselling and support interventions for acceptance of HIV positive status and to help them cope with HIV-related stigma.

HIV Infection and Related Mental Disorders

Over the more than thirty-year period of the human immunodeficiency virus type 1 (HIV-1) epidemic, many data have been accumulated indicating that HIV infection predisposes one to the development of mental pathologies. It has been proven that cognitive disorders in HIV-positive individuals are the result of the direct exposure of the virus to central nervous system (CNS) cells. The use of antiretroviral therapy has significantly reduced the number of cases of mental disorders among people infected with HIV. However, the incidence of moderate to mild cognitive impairment at all stages of HIV infection is still quite high. This review describes the most common forms of mental pathology that occur in people living with HIV and presents the current concepts on the possible pathogenetic mechanisms of the influence of human immunodeficiency virus (HIV-1) and its viral proteins on the cells of the CNS and the CNS’s functions. This review also provides the current state of knowledge on the impact of the antiretroviral therapy on the development of mental pathologies in people living with HIV, as well as current knowledge on the interactions between antiretroviral and psychotropic drugs that occur under their simultaneous administration.

Pharmacodynamics of efavirenz 400 mg in treatment-naïve Chinese HIV-infected patients in a prospective cohort study

BACKGROUND

The plasma concentration of patients treated with efavirenz (EFV) 600 mg was found to exceed the upper limit of the proposed therapeutic window in most Chinese HIV-infected individuals; thus, dosage reduction of EFV to 400 mg daily warranted consideration. This study aimed to assess the pharmacodynamics of EFV 400 mg for HIV-1-infected patients in China.

METHOD

Twenty cART-naïve individuals were enrolled in this study. EFV 400 mg combined with tenofovir (TDF) and lamivudine (3TC) as an initial antiretroviral regimen was administered for 48 weeks. EFV concentration and T cell subsets as well as HIV RNA load were evaluated at baseline and at 4, 12, 24, and 48 weeks. Moreover, neuropsychiatric adverse effects were also assessed by the Hamilton depression (HAMD) scale and Pittsburgh sleep quality index (PSQI).

RESULTS

Eighteen males and two females whose median age was 26 (interquartile range [IQR]: 23-32) years completed 48 weeks of follow-up. The median EFV concentrations were 1.88 (IQR: 1.54-2.42), 1.74 (IQR: 1.36-1.93), 1.93 (IQR: 1.66-2.22), and 1.85 (IQR: 1.54-2.14) mg/L at weeks 4, 12, 24, and 48, respectively. The viral load was 4.59 (IQR: 4.10-5.19) log₁₀ copies/mL at baseline, and it decreased by 4.6 (IQR: 3.98-5.18) log₁₀ copies/mL from baseline to week 48. Three of 20 (15%), 10 of 20 (50.0%), 17 of 20 (85%), and 18 of 19 (95%) participants had a plasma viral load less than 50 copies/mL at weeks 4, 12, 24, and 48, respectively. The median CD4 cell count was 330 (IQR: 237-410) cells/μL at baseline, and it increased to 473 (IQR: 344-574) cells/μL at 48 weeks. The HAMD score was 5 (IQR: 3-9.8) and 3 (IQR: 2.25-4) at baseline and 48 weeks, respectively. The PSQI score was 4 (IQR: 2-5.8) and 3 (IQR: 2-4) at baseline and 48 weeks, respectively. Dizziness was the most common event, occurring in 70% of patients within the first 2 weeks of treatment.

CONCLUSION

Patients prescribed with EFV 400 mg-containing agents demonstrated favourable virological and immunological responses. And the plasma EFV concentration was within the recommended therapeutic range, with fewer adverse reactions than with EFV 600 mg. EFV 400 mg was effective and safe in Chinese HIV-infected patients.

TRIAL REGISTRATION

NCT04596488 ; Registered 21 October, 2020; Retrospectively registered.

Exploring the Relationship Between Anxiety, Depression, and Sleep Disturbance Among HIV Patients in China From a Network Perspective

Background: Mental disorder of people living with HIV (PLWH) has become a common and increasing worldwide public health concern. We aimed to explore the relationship between anxiety, depression, and sleep disturbance for PLWH from a network perspective. Methods: The network model featured 28 symptoms on the Hospital Anxiety and Depression scale questionnaire and Pittsburgh Sleep Quality Index questionnaire in a sample of 4,091 HIV-infected persons. Node predictability and strength were computed to assess the importance of items. We estimated and compared 20 different networks based on subpopulations such as males and females to analyze similarities and differences in network structure, connections, and symptoms. Results: Several consistent patterns and interesting differences emerged across subgroups. Pertaining to the connections, some symptoms such as S12-S13 ("sleepy"-"without enthusiasm") shown a strong positive relationship, indicating that feeling sleepy was a good predictor of lacking enthusiasm, and vice versa. While other symptoms, such as A3-D3 ("worried"-"cheerful"), were negatively related in all networks, revealing that nodes A3 and D3 were bridge symptoms between anxiety and depression. Across all subgroups, the most central symptom was A7 "panic" and S2 "awake", which had the greatest potential to affect an individual's mental state. While S3 "bathroom" and S5 "cough or snore" shown consistent lower node importance, which would be of limited therapeutic use. Conclusions: Mental conditions of PLWH varied considerably among subgroups, inspiring psychiatrists and clinicians that personalized invention to a particular subgroup was essential and might be more effective during treatment than adopting the same therapeutic schedule.

Neuropsychiatric Adverse Events During 12 Months of Treatment With Efavirenz in Treatment-Naïve HIV-Infected Patients in China: A Prospective Cohort Study

Background: Efavirenz (EFV) is widely used in antiretroviral therapy (ART), but the incidence and risk factors of neuropsychiatric adverse events (NPAEs) after EFV treatment have rarely been studied in Chinese ART naïve patients. Methods: This prospective cohort study assessed HIV-infected patients initiating antiretroviral treatment with EFV to determine prevalence of and factors associated with NPAEs over a 12-month follow-up period using the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Results: A total of 546 patients were enrolled. Prevalence of anxiety, depression, and sleep disturbances at baseline were 30.4, 22.7, and 68.1%, respectively. Six patients discontinued treatment due to drug related NPAEs. Treatment was associated with improvements in HADS-A, HADS-D, and PSQI scores over the 12-month follow-up, and the frequencies of patients with anxiety, depression, and sleep disturbances significantly decreased after 12 months. Abnormal baseline HADS-A, HADS-D, and PSQI scores and other factors, including high school education or lower income, unemployment, divorce, and WHO III/IV stages, were associated with severe neuropsychiatric disorders over the 12 months. Conclusions: These findings suggested EFV discontinuation due to NAPEs was low, and the HADS-A, HADS-D, and PSQI scores after 12 months of EFV treatment were associated with several risk factors. The clinicians should keep in mind and routinely screen for the risk factors associated with neuropsychiatric disorders in HIV-infected patients.

Immunological and Psychological Efficacy of Meditation/Yoga Intervention Among People Living With HIV (PLWH): A Systematic Review and Meta-analyses of 19 Randomized Controlled Trials

BACKGROUND

An expanding number of mind-body therapies are being used to reduce the psychological burden of peoples living with human immunodeficiency virus (HIV). However, the effects on the immune system and mental health varied among studies.

PURPOSE

This meta-analysis was conducted to summarize the randomized controlled trials to draw comprehensive conclusions regarding the psycho-immunological efficacy.

METHODS

Random-effects models were used to assess the outcome of interest. Egger's tests were used to identify publication bias. Subgroup and meta-regression were used to explore potential moderators. This review was registered on the PROSPERO database (CRD42019148118).

RESULTS

Nineteen randomized controlled trials with a total sample size of 1,300 were included in this meta-analysis. Regarding immune system outcome, mind-body therapy significantly improved CD4 T-cell counts (Cohen's d = 0.214, p = .027) and maintained (0.427, p = .049). In addition, baseline CD4 T-cell counts and years since HIV diagnosis significantly moderated the efficacy of mind-body practices on CD4 improvement (all ps < .001). Regarding mental health outcome, mind-body therapy significantly reduced stress, depression, and anxiety symptoms (0.422, p < .001; 0.506, p < .001, and 0.709, p < .001, respectively) while improving quality of life (0.67, p < .001).

CONCLUSIONS

Meditation/yoga intervention could result in potential benefits with regard to improved CD4 T-cell counts immediately after the intervention and at long-term follow-up, while also improving their mental health. The cost-effective meditation/yoga intervention should be integrated into routine care for people living with HIV, especially for those with lower CD4 baseline and fewer years since diagnosis.

The Challenge of Potential Drug-Drug Interactions Among People Living With HIV on Antiretroviral Therapy: A Cross-Sectional Study in Selected Provinces in China

Objectives

Potential drug–drug interactions (DDIs) are a significant therapeutic threat among human immunodeficiency virus (HIV)-positive individuals on antiretroviral (ARV) medications. DDIs involving ARV drugs in mainland China are unknown and insufficiently described. Herein, we investigated the prevalence and frequencies of potential ARV DDIs in Chinese people living with HIV (PLWH), then we assessed the risk factors associated with potential DDIs.

Methods

This study was conducted with HIV-positive adults undergoing ARV medications from multiple centers across China. The latest prescription of each participant was evaluated for potential DDIs using the Liverpool HIV drug interaction database. Multivariable logistic regressions were used to evaluate the factors associated with DDIs.

Results

Among 600 PLWH recruited, at least one non-HIV co-medication was observed in 511 (85.2%) individuals. A total of 2566 DDIs were identified, of which 11 (0.43%) and 311 (12.89%) were of contraindicated (red-flags) and dosage/timing adjustment required (orange-flags), respectively. Multivariate regression analysis revealed a higher risk of clinically significant DDIs (red- and orange-flagged comedication) associated with: the use of boosted protease inhibitors (p < 0.0001), boosted integrase strand transfer inhibitors (p < 0.0001), and non-nucleoside reverse transcriptase inhibitors-based ARV regimen (p < 0.0001); or the use of antiinfectives for systemic use (p < 0.0001), cardiovascular system drugs (p < 0.0001), nervous system drugs (p < 0.0001), fungal infection (p = 0.0071), and Herpes simplex virus infection (p = 0.0231).

Conclusions

Potential DDIs and inappropriate medications constitute a burden for people living with HIV in China. The knowledge of DDIs patterns and the scan for DDIs is crucial. Indeed, they can help to prevent drug-related adverse outcomes in such immunodeficient population.

Anxiety and depression among HIV patients of the infectious disease department of Conakry University Hospital in 2018

Anxiety and depression continue to be significant comorbidities for people with human immunodeficiency virus (HIV) infection. The aim of this study was to determine the prevalence of anxiety and depression disorder among HIV patients at Conakry, Guinea. In this cross-sectional study, we described socio-demographic, clinical and psychosocial data related to anxiety and depression in 160 HIV patients of the University Teaching Hospital, Conakry, Guinea. The Hospital Anxiety and Depression Scale (HADS) was used for measuring depression and anxiety in the prior month. The HADS score of ⩾8 was used to identify possible cases of depression and anxiety. Multivariate logistic regression analyses were performed to identify factors associated with symptoms of anxiety and depression. The prevalence of comorbid depression and anxiety among HIV patients was 8.1% and the prevalence of anxiety and depressive symptoms among HIV-infected patients was 13.8% and 16.9%, respectively. Multivariate analysis showed that individuals having BMI ⩽ 18 (AOR = 3.62, 95% confidence interval (CI) 1.37-9.57) and who did not receive antiretroviral treatment (AOR = 18.93, 95% CI 1.88-188.81) were significantly more likely to have depressive symptoms. Similarly, having age <40 years (AOR = 2.81, 95% CI 1.04-7.58) was also significantly associated with anxiety. Prevalence of symptoms of anxiety and depression was high in these HIV patients. This suggests a need for training on the screening and management of anxiety and depression among HIV patients.