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首页> 外文期刊>AIDS care. >Depression and symptomatic response among HIV-infected drug users enrolled in a randomized controlled trial of directly administered antiretroviral therapy.
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Depression and symptomatic response among HIV-infected drug users enrolled in a randomized controlled trial of directly administered antiretroviral therapy.

机译：参加直接给药抗逆转录病毒疗法的随机对照试验的HIV感染药物使用者的抑郁和症状反应。

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BACKGROUND: Depression is highly prevalent among HIV-infected injection drug users (IDUs) and has been associated with poor adherence to antiretroviral therapy and increased morbidity and mortality. Factors associated with changes in depressive symptoms among this group receiving antiretroviral treatment that have not been extensively evaluated. METHODS: This post-hoc analysis of prospective clinical trial analyzes the factors associated with changes in depressive symptomatology using the Center for Epidemiologic Studies of Depression Scale (CES-D) among HIV-infected IDUs enrolled in a prospective, six months randomized controlled trial of directly administered antiretroviral therapy (DAART) versus self-administered therapy. RESULTS: Of the 127 evaluable IDUs enrolled in the study, 89 subjects (70%) had complete six-month follow-up data. Of these, 58 (63%) met baseline criteria for severe or major depressive disorder (MDD) using the CES-D. CES-D scores improved significantly from baseline to six months overall for the 89 subjects (p=0.01) and for the 58 who had MDD with six-month data (p=0.001). Using multiple regression, an improvement in CES-D score was independently associated with: (1) increase in CD4 count; (2) increase in adherence; (3) non-Caucasian race; and (4) older age. Worsening in CES-D score was associated with: (1) increase in HIV-1 RNA levels; (2) homelessness; (3) poor self-efficacy; (4) active drug use; and (5) male gender. Factors not correlated with changes in CES-D were receipt of DAART, engagement in drug treatment, use of antidepressant medication, and employment. Using generalized estimating equation modeling, factors that remained positively associated with improvements in CES-D score were absence of drug use at six months, having housing, higher self-efficacy, increase in CD4 count and increases in adherence. CONCLUSION: Improvements in depressive symptoms could occur with improvement of alterable factors that are associated with strengthening adherence such as linkages to case management, mental health and substance abuse treatment services as well as through enhancement of social stabilization factors through social support and supportive housing.
机译：背景：抑郁症在感染了HIV的注射吸毒者（IDU）中非常普遍，并且与抗逆转录病毒疗法依从性差，发病率和死亡率增加有关。在接受抗逆转录病毒治疗的这一组中，与抑郁症状变化有关的因素尚未得到广泛评估。方法：本前瞻性临床试验的事后分析使用抑郁症流行病学研究中心量表（CES-D）对参与一项前瞻性，六个月随机对照试验的HIV感染IDU中的抑郁症状症状变化进行分析。直接服用抗逆转录病毒疗法（DAART）与自我服用疗法。结果：在该研究中纳入的127个可评估的吸毒者中，有89个受试者（70％）具有完整的六个月随访数据。其中有58名（63％）使用CES-D达到了严重或重度抑郁症（MDD）的基线标准。 CES-D分数从基线到六个月总体上显着改善，共有89位受试者（p = 0.01）和58位具有六个月数据的MDD受试者（p = 0.001）。使用多元回归分析，CES-D评分的改善与以下因素独立相关：（1）CD4计数增加; （2）增加依从性; （3）非高加索人; （4）年龄较大。 CES-D评分恶化与以下因素有关：（1）HIV-1 RNA水平升高; （2）无家可归; （3）自我效能差; （4）积极用药; （5）男性。与CES-D变化无关的因素包括DAART的接收，参与药物治疗，使用抗抑郁药和就业。使用广义估计方程模型，与CES-D得分改善保持正相关的因素是六个月内没有药物使用，住房，自我效能较高，CD4计数增加和依从性增加。结论：抑郁症状的改善可能与改善依从性相关的可变因素的改善有关，例如与病例管理，心理健康和药物滥用治疗服务的联系以及通过社会支持和支持性住房来增强社会稳定因素。

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