HIV and Depression Associated With Decrease Survival Among Veterans

Findings from the Veterans Aging Cohort Study indicated that depression and HIV status predict all-cause mortality.

Depression has been linked to high rates of all-cause mortality in patients with HIV, according to research presented at IDWeek 2016.1

Samir Gupta, MD, MS, of the Indiana University School of Medicine in Indianapolis, and colleagues conducted an analysis of the Veterans Aging Cohort Study (VACS) to determine the relationship between depression, HIV infection, and all-cause mortality.

Baseline depressive major depressive disorder (MDD) and HIV status were identified in all participants using ICD-9 codes; baseline depression was identified in the corresponding Tissue Repository Cohort by a Patient Health Questionnaire (PHQ)-9 score ≥10.

Median follow-up was 10 years (interquartile range [IQR]: 5.6-12.1) in the VACS and 8.8 years (IQR: 8-9.3) in the Tissue Repository Cohort. In the VACS, unadjusted hazard ratios [HR] for mortality were 1.2 (95% confidence interval [CI], 1.1-1.3; P <.001) in the HIV-/MDD+ group; 2.4 (95% CI, 2.3-2.5; P <.001) in the HIV+/MDD- group; and 2.5 (95% CI, 2.3-2.6; P <.001) in the HIV+/MDD+ group, compared with subjects who were both HIV and MDD negative.

Among participants in the Tissue Repository Cohort, unadjusted HRs for mortality were 1.4 (95% CI, 0.8-2.4; P =.20) in the HIV-/MDD+ group; 1.9 (95% CI, 1.3-2.8; P <.001) in the HIV+/MDD- group; and 2.7 (95% CI: 1.7-4.1; P <.001) in the HIV+/MDD+ group, compared who subjects who were HIV- and MDD negative.

In overall and HIV-1 RNA <500 c/mL analyses in the VACS, 14.4% and 12.5% of participants died; in the Tissue Repository Cohort, patient deaths were 13.5% and 10.7%, respectively.

“In analyses using both diagnostic codes and a more sensitive instrument for identifying depression, we found that depression in combination with HIV infection was strongly associated with increased all-cause mortality,” Dr Gupta and colleagues concluded.

Disclosures: Dr Gupta reports relationships with Gilead Sciences, Bristol-Myers Squibb, and Janssen Therapeutics.

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  1. Gupta S, So-Armah K, Stewart J, Chang J, Goulet JL, Freiberg M. Depression and HIV infection are associated with higher risks of all-cause mortality in US veterans: a cohort study. Presented at: IDWeek 2016; October 26-31, 2016; New Orleans, LA. Poster 2179.