Depression and virological status among UK HIV outpatients: results from a multicentre study

F. Lampe, A. Speakman, A. Phillips, L. Sherr, R. Gilson, M. Johnson, M. Fisher, J. Anderson, E. Wilkins, C. Broussard, J. McDonnell, N. Perry, R. Scourse, V. George, G. Hart, A. Johnson, S. Collins, A. Miners, J. Elford, A-M GerettiW. Burman, A. Rodger

Research output: Contribution to journalMeeting abstractpeer-review

Abstract

Background: Mental health has been highlighted as a current priority area in HIV care, but there have been few large studies of mental health issues among UK HIV patients. Methods: We used a validated diagnostic questionnaire to assess the prevalence of depression, and its association with virological status, in ASTRA (Antiretrovirals, Sexual Transmission Risk and Attitudes), a multicentre UK study of over 3000 HIV outpatients in 2011/12. The ‘PHQ-9’ symptom questions classified participants according to (i)presence/absence of ‘depres- sive disorder’ and (ii)’depression symptom score’ (none; minimal; mild; moderate; severe). Participants also reported any current (medical or other) treatment for depression. ART non-adherence was defined as ‡1 missed dose in the past 2 weeks. Latest viral load (VL) at questionnaire completion was recorded from clinic databases. Associations were assessed using Chi-squared tests and logistic regression. Results: Data are presented for the first 1227 participants [18% women; 73% MSM; 9% heterosexual men]. Mean age was 45.3 years. Ethnic classification was:70% white; 17% Black African; 13% other ethnicity. 925 patients (75.4%) were currently on ART for ‡3 months, of whom 9.5% had latest VL>50c/mL. Overall, the prevalence of depressive disorder was 22.2% (273/ 1227) and did not vary by risk group, age, ethnicity, or ART use(p>0.2). Among the 925 patients on ART, the prevalence of VL>50c/mL was much higher among those with depressive disorder compared to those without [16.3% (34/ 209) vs 7.5% (54/716), p<0.001]. Prevalence of VL>50c/mL rose with increasing depression symptom score [5.7%; 6.0%; 11.7%; 12.0%; 21.7% for 5 categories from none to severe, p<0.001 for trend]. The association of depressive disorder with VL>50c/mL persisted after adjustment for non- adherence [odds ratios(95% CI):2.4(1.5, 3.8) and 2.3(1.4, 3.6) for unadjusted and adjusted respectively]. Of all 273 patients with depressive disorder, 120 (44.0%) were receiving treatment for depression. A further 140 patients were being treated for depression with no depressive disorder symptoms [total treated or symptoms:413/1227 (33.7%)]. Conclusions: One in three UK HIV outpatients were either receiving treatment for depression or had symptoms of depressive disorder. Among ART-treated patients, depressive symptoms were strongly and consistently associated with non-suppression of VL, emphasising the importance of identification and management of depression in HIV clinical care
Original languageEnglish
Article numberO10
Pages (from-to)4-4
Number of pages1
JournalHIV Medicine
Volume13
Issue numberS1
Publication statusPublished - 20 Apr 2012

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