TY - JOUR
T1 - Psychosocial and Neurohormonal Predictors of HIV Disease Progression (CD4 Cells and Viral Load)
T2 - A 4 Year Prospective Study
AU - Ironson, G.
AU - O’Cleirigh, C.
AU - Kumar, M.
AU - Kaplan, L.
AU - Balbin, E.
AU - Kelsch, C. B.
AU - Fletcher, M. A.
AU - Schneiderman, N.
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media New York.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2015/8/6
Y1 - 2015/8/6
N2 - Most studies of psychosocial predictors of disease progression in HIV have not considered norepinephrine (NE), a neurohormone related to emotion and stress, even though NE has been related to accelerated viral replication in vitro and impaired response to antiretrovial therapy (ART). We therefore examined NE, cortisol, depression, hopelessness, coping, and life event stress as predictors of HIV progression in a diverse sample. Participants (n = 177) completed psychological assessment, blood draws [CD4, viral load (VL)], and a 15 h urine sample (NE, cortisol) every 6 months over 4 years. Hierarchical linear modeling (HLM) was used to model slope in CD4 and VL controlling for ART at every time point, gender, age, race, SES, and initial disease status. NE (as well as depression, hopelessness, and avoidant coping) significantly predicted a greater rate of decrease in CD4 and increase in VL. Cortisol was not significantly related to CD4, but predicted VL increase. To our knowledge, this is the first study relating NE, in vivo, to accelerated disease progression over an extended time. It also extends our previous 2 year study by relating depressed mood and coping to accelerated disease progression over 4 years.
AB - Most studies of psychosocial predictors of disease progression in HIV have not considered norepinephrine (NE), a neurohormone related to emotion and stress, even though NE has been related to accelerated viral replication in vitro and impaired response to antiretrovial therapy (ART). We therefore examined NE, cortisol, depression, hopelessness, coping, and life event stress as predictors of HIV progression in a diverse sample. Participants (n = 177) completed psychological assessment, blood draws [CD4, viral load (VL)], and a 15 h urine sample (NE, cortisol) every 6 months over 4 years. Hierarchical linear modeling (HLM) was used to model slope in CD4 and VL controlling for ART at every time point, gender, age, race, SES, and initial disease status. NE (as well as depression, hopelessness, and avoidant coping) significantly predicted a greater rate of decrease in CD4 and increase in VL. Cortisol was not significantly related to CD4, but predicted VL increase. To our knowledge, this is the first study relating NE, in vivo, to accelerated disease progression over an extended time. It also extends our previous 2 year study by relating depressed mood and coping to accelerated disease progression over 4 years.
KW - Coping
KW - Disease progression
KW - HIV/AIDS
KW - Norepinephrine
KW - Stress
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U2 - 10.1007/s10461-014-0877-x
DO - 10.1007/s10461-014-0877-x
M3 - Article
C2 - 25234251
AN - SCOPUS:84938745158
VL - 19
SP - 1388
EP - 1397
JO - AIDS and Behavior
JF - AIDS and Behavior
SN - 1090-7165
IS - 8
ER -