Abstract
Background: In vitro evidence has suggested that increasing levels of norepinephrine (NE) can accelerate HIV replication; however, the importance in a clinical setting has not been tested. Purpose: The purpose of this study was to determine if perceived stress as well as the stress hormones NE and cortisol would predict the response to starting a new protease inhibitor (PI) prospectively. Method: Perceived stress, urinary cortisol and norepinephrine, CD4 and viral load (VL) were measured in people with HIV before starting a new PI and six months later (an average of three months after starting the new PI) in order to determine CD4 and VL response to the PI. Results: Higher perceived stress significantly predicted lower effectiveness of the new PI in increasing CD4 and decreasing VL controlling for age, duration of new PI, baseline CD4/VL, sexually transmitted diseases (STDs), and gender/ethnic risk groups. Higher norepinephrine, but not cortisol, predicted worse VL response to PIs and, in fact, mediated the relationship between perceived stress and change in VL. Conclusion: Perceived stress and high norepinephrine levels are prospectively associated with a poorer response to starting a new PI. Assessing stress and norepinephrine levels in patients starting on antiretroviral medications might be clinically useful.
| Original language | English |
|---|---|
| Pages (from-to) | 221-226 |
| Number of pages | 6 |
| Journal | International Journal of Behavioral Medicine |
| Volume | 15 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jul 1 2008 |
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Keywords
- Cortisol
- HAART
- HIV
- Norepinephrine
- Protease inhibitors
- Stress
ASJC Scopus subject areas
- Psychology(all)
- Clinical Psychology
Cite this
Perceived stress and norepinephrine predict the effectiveness of response to protease inhibitors in HIV. / Ironson, Gail; Balbin, Elizabeth; Stieren, Emily; Detz, Kelly; Fletcher, Mary Ann; Schneiderman, Neil; Kumar, Mahendra.
In: International Journal of Behavioral Medicine, Vol. 15, No. 3, 01.07.2008, p. 221-226.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Perceived stress and norepinephrine predict the effectiveness of response to protease inhibitors in HIV
AU - Ironson, Gail
AU - Balbin, Elizabeth
AU - Stieren, Emily
AU - Detz, Kelly
AU - Fletcher, Mary Ann
AU - Schneiderman, Neil
AU - Kumar, Mahendra
PY - 2008/7/1
Y1 - 2008/7/1
N2 - Background: In vitro evidence has suggested that increasing levels of norepinephrine (NE) can accelerate HIV replication; however, the importance in a clinical setting has not been tested. Purpose: The purpose of this study was to determine if perceived stress as well as the stress hormones NE and cortisol would predict the response to starting a new protease inhibitor (PI) prospectively. Method: Perceived stress, urinary cortisol and norepinephrine, CD4 and viral load (VL) were measured in people with HIV before starting a new PI and six months later (an average of three months after starting the new PI) in order to determine CD4 and VL response to the PI. Results: Higher perceived stress significantly predicted lower effectiveness of the new PI in increasing CD4 and decreasing VL controlling for age, duration of new PI, baseline CD4/VL, sexually transmitted diseases (STDs), and gender/ethnic risk groups. Higher norepinephrine, but not cortisol, predicted worse VL response to PIs and, in fact, mediated the relationship between perceived stress and change in VL. Conclusion: Perceived stress and high norepinephrine levels are prospectively associated with a poorer response to starting a new PI. Assessing stress and norepinephrine levels in patients starting on antiretroviral medications might be clinically useful.
AB - Background: In vitro evidence has suggested that increasing levels of norepinephrine (NE) can accelerate HIV replication; however, the importance in a clinical setting has not been tested. Purpose: The purpose of this study was to determine if perceived stress as well as the stress hormones NE and cortisol would predict the response to starting a new protease inhibitor (PI) prospectively. Method: Perceived stress, urinary cortisol and norepinephrine, CD4 and viral load (VL) were measured in people with HIV before starting a new PI and six months later (an average of three months after starting the new PI) in order to determine CD4 and VL response to the PI. Results: Higher perceived stress significantly predicted lower effectiveness of the new PI in increasing CD4 and decreasing VL controlling for age, duration of new PI, baseline CD4/VL, sexually transmitted diseases (STDs), and gender/ethnic risk groups. Higher norepinephrine, but not cortisol, predicted worse VL response to PIs and, in fact, mediated the relationship between perceived stress and change in VL. Conclusion: Perceived stress and high norepinephrine levels are prospectively associated with a poorer response to starting a new PI. Assessing stress and norepinephrine levels in patients starting on antiretroviral medications might be clinically useful.
KW - Cortisol
KW - HAART
KW - HIV
KW - Norepinephrine
KW - Protease inhibitors
KW - Stress
UR - http://www.scopus.com/inward/record.url?scp=49449085615&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=49449085615&partnerID=8YFLogxK
U2 - 10.1080/10705500802219606
DO - 10.1080/10705500802219606
M3 - Article
C2 - 18696316
AN - SCOPUS:49449085615
VL - 15
SP - 221
EP - 226
JO - International Journal of Behavioral Medicine
JF - International Journal of Behavioral Medicine
SN - 1070-5503
IS - 3
ER -