The Association between CD-4 Level, Stress and Depression Symptoms among People Living with HIV/AIDS

BACKGROUND:

The lives of individuals diagnosed with HIV and the subsequent illness, AIDS, were often chaotic because these individuals deal with the physical, emotional, and interpersonal sequelae of this illness. Depressive symptoms and stress were common and impact on functioning, quality of life, and health status, highlighting the importance of diagnosis and treatment of patients with HIV infection. Psychiatric clinical practice and rating scales have come to play an ever-increasing role both in determining specific symptoms and diagnosing an individual condition. Descriptive reports of psychiatric morbidity among those with HIV infection, that relied primarily on self-report rating scales, described high rates of symptomatic depression and stress.

AIM:

This study aimed to determine the proportion of depression among people living with HIV/AIDS using the BDI-II and PSS to determine a relationship between symptoms of depression and stress with CD4 counts.

METHODS:

This study was a numerical correlative analytic study with a cross-sectional study approach that assessed the correlation between stress, depression and CD4 level in people with HIV/AIDS that were receiving ARV therapy in the Voluntary Counselling Test (VCT) Polyclinic of General Hospital Haji Medan by recruiting 46 subjects. CD4 level was examined in the Pramita Medan laboratory.

RESULTS:

When analysis of BDI-II level and CD4 scores were done, a significant correlation was found (P < 0.05). The strength of the relationship between the BDI score and the CD4 score was 0.548 revealing a positive correlation with moderate correlation strength

CONCLUSION:

We have shown a significant relationship between depression, stress and CD4 level among people with HIV/AIDS in Medan, Indonesia. Psychological distress may affect the immunity in infected people, leading to the disease progressivity.

Screening of Mental Disorders Related CD4 Count of People Living with HIV/AIDS with Anti-Retroviral Treatment in Medan, Indonesia

BACKGROUND:

Mental disorders are the most common problems in the life of People Living with HIV/AIDS (PLWHA). The frequency in which HIV/AIDS and mental health problems co-exist, and the complex bi-directional relationship between them. Several biological, distress psychological and social dysfunction factors are associated with mental disorders in PLWHA.

AIM:

To analyse the relationship between the screening of mental disorders using General Health Questionnaire-12 scores and CD4 counts of People Living with HIV/AIDS with Anti-Retroviral Treatment.

METHODS:

This was a correlative analytical study with a cross-sectional approach using the General Health Questionnaire-12 (GHQ-12) instrument to assess screening mental disorders and the CD4 count. This research was conducted in February 2019 – April 2019 at an HIV/AIDS outpatient clinic. As many 33 subjects were divided into inclusion criteria; participant confirmed HIV seropositivity in stage II or III were undergoing ARV treatment, ranged in age between 25-49 years. The duration of HIV disease was ≤ four years, and the duration of ARV treatment was ≥ six months and informed consent to participate in the study. The patient who had mental disorders and currently drugs user was excluded from this study.

RESULTS:

There was an association found between change in CD4 and screening mental disorders at univariate analysis among the study participants, whether on antiretroviral treatment. The correlation between the total GHQ-12 scores as a screening of mental disorders and CD4 counts indicated to result in a significant negative correlation, r = -0.670 with p = 0.001.

CONCLUSION:

Screening mental disorders using General Health Questionnaire-12 from the results of this study shows that it is important to do for PLWHA because with low CD4 levels as biomarkers the progression of HIV infection affects psychological distress and social dysfunction in people living with HIV who have the potential for symptoms of mental disorders.