C-reactive protein and depression in persons with Human Immunodeficiency Virus infection: The Positive Living with HIV (POLH) Study |
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| Institution: | 1. AIDS Clinical Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan;2. Division of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, 409 Arnold House, 715 North Pleasant Street, Amherst, MA 01003-9304, USA;3. School of Community and Global Health, Claremont Graduate University, 675 West Foothill Boulevard, Suite 310, Claremont, CA 91711-3475, USA;4. Department of Public Health, School of Public Health and Health Sciences, University of Massachusetts Amherst, 316 Arnold House, 715 North Pleasant Street, Amherst, MA 01003-9304, USA;1. Ministry of Health and Family Welfate, New Delhi-70, India;2. WHO Regional Office for South-East Asia, New Delhi 110002, India;1. Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania;2. Department of Health & Nutritional Sciences, Box 2203 SAB 116, South Dakota State University, Brookings, SD 57007, United States;3. Department of Internal Medicine, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands;4. Department of Pediatric Infectious Diseases and Immunology, VUmc University Medical Center, Amsterdam, The Netherlands;5. Division of Infectious Diseases and International Health, Department of Medicine, Duke University Medical Center, and Duke Global Health Institute, 310 Trent Drive, Durham, NC 27708, United States;1. Centre for Sexual Health and HIV AIDS Research Zimbabwe, Harare, Zimbabwe;2. Research Department of Infection and Population Health, University College London, London WC1E 6AU, UK;1. The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052 Copenhagen, Denmark;2. The Rockwool Foundation, Ny Kongensgade 6, 1472 Copenhagen, Denmark;1. Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, 30625 Hannover, Germany |
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| Abstract: | BackgroundHuman Immunodeficiency Virus (HIV) infection has been frequently associated with chronic inflammation as well as depression. C-reactive protein (CRP) is positively associated with depression in people without HIV infection. We tested the hypothesis of an independent relationship between CRP and depression in a cohort of HIV-positive people.MethodsA cross-sectional survey was conducted among 316 HIV-positive people (181 men and 135 women) aged 18–60 years residing in the Kathmandu Valley, Nepal. The latex agglutination turbidimetric method was used to measure serum CRP concentrations and the Beck Depression Inventory (BDI)-I method was used to measure depression, with a cut off of ?20 indicating likely depression. The relationship between CRP concentrations and depression symptoms was assessed using both multiple linear regression analysis and multiple logistic regression analysis, with adjustment for potential socio-demographic, cardiovascular, life-style, and HIV-related clinical and treatment confounding factors.ResultsTwenty-six percent participants (men: 23%; women: 29%) met criteria for depression. In multiple regression analysis, the authors observed a linear relation between serum CRP concentrations and BDI score (beta for 1 unit change in ln(CRP) = 1.13, p = 0.001) in HIV-positive participants. In a logistic regression analysis, participants with serum CRP levels > 3 mg/L had a 2.3-fold higher odds of depression symptoms compared to those with serum CRP level ? 3 mg/L (p = 0.005). In analyses stratified by sex, associations were stronger in men than in women. For example, CRP > 3 mg/L was associated with a 3.6-fold higher odds of depression in men (p = 0.002), while in women the odds ratio was 1.7 (p = 0.33).ConclusionWe found a linear relationship between serum CRP concentrations and depression symptoms score in HIV-positive people, and evidence that risk of depression is elevated among HIV-positive men with a high level of inflammation (CRP > 3 mg/L). Further prospective study to confirm the role of inflammation in depression among HIV-positive people is warranted. |
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| Keywords: | HIV C-reactive protein Depression Nepal |
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