Document Detail

Psychological distress is associated with decreased memory helper T-cell and B-cell counts in pre-AIDS HIV seropositive men and women but only in those with low viral load.
MedLine Citation:
PMID:  12883114     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Although some studies have demonstrated the association of psychological distress and diminished immune system function in HIV spectrum disease, other studies have yielded apparently conflicting findings; the lack of consideration of the role of HIV viral burden may be central to this controversy. This study examined whether HIV viral burden moderated the relationship between psychological distress and enumerative and functional immune measures in pre-AIDS HIV spectrum disease. METHODS: This cross-sectional study used factor analysis to derive a composite measure of psychological distress incorporating measures of dysphoria, anxiety, and perceived stress. Multiple regression analyses used distress as the predictor, immune measures as the outcome variables, with viral load as the moderator variable, while controlling for age, medication use, and HIV symptomatology. Subjects were 148 pre-AIDS, HIV seropositive men and women (89 asymptomatic, 59 symptomatic), aged 18 to 45 years. The main outcome measures were enumerative and functional immune measures. RESULTS: A model of psychological distress was derived using each of the proposed measures. Findings indicated that high distress was associated with decreased numbers of helper T (memory) cells and B cells, but only at low levels of viral burden after controlling for age, medication use, and HIV-related symptoms. CONCLUSIONS: These findings highlight the importance of assessing the role of HIV viral burden when examining distress-immunity relationships in HIV-infected individuals. The lack of association in those persons with high viral load suggests that, even before AIDS onset, disease-related processes are disrupting CNS and immune system communication.
Sarosh J Motivala; Barry E Hurwitz; Maria M Llabre; Nancy G Klimas; Mary Ann Fletcher; Michael H Antoni; William G LeBlanc; Neil Schneiderman
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Psychosomatic medicine     Volume:  65     ISSN:  1534-7796     ISO Abbreviation:  Psychosom Med     Publication Date:    2003 Jul-Aug
Date Detail:
Created Date:  2003-07-28     Completed Date:  2004-04-29     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0376505     Medline TA:  Psychosom Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  627-35     Citation Subset:  IM    
Behavioral Medicine Research Center, University of Miami, Miami, Florida 33125, USA.
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MeSH Terms
Anti-HIV Agents / therapeutic use
B-Lymphocytes / immunology*
Cross-Sectional Studies
HIV Seropositivity / drug therapy,  immunology,  psychology*
Immunologic Memory*
Lymphocyte Activation / drug effects
Lymphocyte Count*
Middle Aged
Phytohemagglutinins / pharmacology
Stress, Psychological / immunology*
T-Lymphocytes, Helper-Inducer / immunology*
Viral Load
Viremia / drug therapy,  immunology,  psychology*
Grant Support
Reg. No./Substance:
0/Anti-HIV Agents; 0/Phytohemagglutinins

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