Antiretroviral treatment has transformed HIV from a death sentence to a chronic condition, enabling infected adults to pay more attention to their quality of life. Yet quality of life is affected strongly by depression, which plagues HIV-infected adults at a higher rate than the general population.
Photo: Quality of life (QOL) is affected strongly by depression, which plagues HIV-infected adults at a higher rate than the general population. A UNC study found that treating depression of people with HIV improves QOL in a number of areas. [Photo of Panamanian clinic patient, courtesy of edllanem/creative commons-flickr.]
A new study by Dr. Brian Pence, assistant professor of epidemiology, and doctoral candidate Ms. Angela Bengtson, both of UNC’s Gillings School of Global Public Health, indicates that treating depression effectively improves quality of life in a number of areas for HIV-infected individuals.
The study, “Improvements in depression and changes in quality of life among HIV-infected adults,” was published online Aug. 8 in the journal AIDS Care.
“It is pretty well understood that depression is associated with worse quality of life,” Ms. Bengtson said. “But this is some of the first evidence about the extent to which improving depression has the potential to improve quality of life for patients with HIV infection.”
Living with HIV carries considerable physical and emotional burdens. Physical symptoms, especially extreme fatigue, take their toll, and HIV continues to bear a stigma that can lead to loss of social support among infected adults. When depression joins the mix, which it does in 20 to 30 percent of infected adults, it can decrease adherence to taking antiretroviral drugs, which can start a downward spiral leading to reduced quality of life and worse health outcomes.
The study by Ms. Bengtson and Dr. Pence was part of a larger randomized controlled trial comparing enhanced care for depression to a treatment model called Measurement-Based Care. The paper examines the first 176 study participants who completed six months of follow-up in the larger study. The researchers measured the participants’ level of depression at the beginning of the study and again after six months, using the Hamilton Depression Rating Scale (HAM-D), and classified each participant as showing full, partial or no relief from their depression. Those who experienced greater relief from their depression reported better quality of life — including better mental health-related daily functioning and reductions in HIV symptoms and fatigue — than those who demonstrated only partial or no relief from their depression.
The results support the idea that treating depression in HIV-infected adults holds the likelihood of improving important indicators of quality of life.
Co-authors affiliated with UNC are Ms. Julie O’Donnell, research assistant in the Gillings School’s epidemiology department; Ms. Amy Heine, of the UNC School of Medicine’s Department of Medicine; and Dr. Bradley Gaynes, of the UNC medical school’s psychiatry department.