HIV Status May Increase Risk of Death Associated with Depression

A new study focusing on the relationship between depressive disorders or symptoms, HIV status, and mortality has found that the symptoms of depression are moderately associated with death among veterans with HIV, but not among those without HIV infection.

Investigators from the Boston University School of Medicine (BUSM) used data from participants of the Veteran’s Aging Cohort Study to compare the risk of death among US veterans who were depressed to those not suffering from depression. The authors then compared the association between depression and death among those with HIV to those without HIV. Depression was measured by both clinical diagnostic codes and by a depressive symptom questionnaire.

Among those with an HIV infection, investigators found a 23% increased mortality risk associated with elevated depressive symptoms through the questionnaire, but they did not find an increased mortality risk in depression through the diagnostic codes.

For uninfected people, there was a 6% increased mortality risk associated with depressive disorders measured by diagnostic codes but no significant increased mortality risk for elevated depressive symptoms assessed by the questionnaire.

The investigators indicated the importance of screening and treatment for depression, especially among those living with HIV, since there has been an increase in life expectancy for those suffering from HIV due to life-saving antiretroviral therapy.

"Our findings reinforce the need to assess and treat depressive symptoms and major depressive disorder in patients with and without HIV infection to potentially reduce mortality risk," corresponding author Kaku So-Armah, PhD, assistant professor of medicine at BUSM, said in a press release.

Despite clinical guidelines recommending routine screening for depressive symptoms, there is varying success in implementation, which results in under diagnosis of depression among people with HIV infection, according to the press release.

"This needs to be improved; better understanding of barriers to and facilitators of effective depression screening and integration of depression treatment into HIV primary care is needed," So-Armah said.