Peter Siyahhan Julnes1, Sungyoung Auh2, Rebecca Krakora3, Keenan Withers4, Diana Nora4, Lindsay Matthews3, Sally Steinbach5, Joseph Snow4, Bryan Smith6, Avindra Nath6, Caryn Morse3, Suad Kapetanovic7. 1. Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD. Electronic address: peterselim.siyahhanjulnes@nih.gov. 2. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. 3. Critical Care Medicine Department, National Institutes of Health, Bethesda, MD. 4. National Institute of Mental Health, National Institutes of Health, Bethesda, MD. 5. Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc, Frederick, MD. 6. Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD. 7. National Institute of Mental Health, National Institutes of Health, Bethesda, MD; Department of Psychiatry and The Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Abstract
BACKGROUND: Post-traumatic stress disorder (PTSD) may be associated with chronic immune dysregulation and a proinflammatory state. Among HIV-infected individuals, PTSD is associated with greater morbidity and mortality, but the association with immune dysfunction has not been evaluated. This study explores the association between PTSD and selected markers of inflammation and immune activation in a cohort of HIV-infected, virally-suppressed individuals. METHODS: HIV-infected adults who were virologically controlled on antiretroviral medications were recruited through a screening protocol for studies of HIV-related neurocognitive disorders. Each participant underwent blood draws, urine toxicology screen, and completed the Client Diagnostic Questionnaire, a semistructured psychiatric interview. RESULTS: Of 114 eligible volunteers, 72 (63%) were male, 77 (68%) African American, and 34 (30%) participants met criteria for PTSD. Participants with PTSD were more likely to be current smokers (79%) than those without (60%) (p = 0.05). The PTSD cohort had significantly higher total white blood cell counts (5318 and 6404 cells/uL, p = 0.03), absolute neutrophil count (2767 and 3577 cells/uL, p = 0.02), CD8% (43 and 48, p = 0.05), and memory CD8% (70 and 78%, p = 0.04); lower naïve CD8% (30 and 22%, p = 0.04) and higher rate of high-sensitivity C-reactive protein >3mg/L (29 and 20, p = 0.03). DISCUSSION: A high prevalence of PTSD was identified in this cohort of HIV-infected adults who were virally suppressed. These results suggest that PTSD may be associated with immune dysregulation even among antiretroviral therapy-adherent HIV-infected individuals. Published by Elsevier Inc.
BACKGROUND: Post-traumatic stress disorder (PTSD) may be associated with chronic immune dysregulation and a proinflammatory state. Among HIV-infected individuals, PTSD is associated with greater morbidity and mortality, but the association with immune dysfunction has not been evaluated. This study explores the association between PTSD and selected markers of inflammation and immune activation in a cohort of HIV-infected, virally-suppressed individuals. METHODS:HIV-infected adults who were virologically controlled on antiretroviral medications were recruited through a screening protocol for studies of HIV-related neurocognitive disorders. Each participant underwent blood draws, urine toxicology screen, and completed the Client Diagnostic Questionnaire, a semistructured psychiatric interview. RESULTS: Of 114 eligible volunteers, 72 (63%) were male, 77 (68%) African American, and 34 (30%) participants met criteria for PTSD. Participants with PTSD were more likely to be current smokers (79%) than those without (60%) (p = 0.05). The PTSD cohort had significantly higher total white blood cell counts (5318 and 6404 cells/uL, p = 0.03), absolute neutrophil count (2767 and 3577 cells/uL, p = 0.02), CD8% (43 and 48, p = 0.05), and memory CD8% (70 and 78%, p = 0.04); lower naïve CD8% (30 and 22%, p = 0.04) and higher rate of high-sensitivity C-reactive protein >3mg/L (29 and 20, p = 0.03). DISCUSSION: A high prevalence of PTSD was identified in this cohort of HIV-infected adults who were virally suppressed. These results suggest that PTSD may be associated with immune dysregulation even among antiretroviral therapy-adherent HIV-infected individuals. Published by Elsevier Inc.
Authors: Kathleen M Malee; Claude A Mellins; Yanling Huo; Katherine Tassiopoulos; Renee Smith; Patricia A Sirois; Susannah M Allison; Deborah Kacanek; Suad Kapetanovic; Paige L Williams; Mitzie L Grant; Daniel Marullo; Angela A Aidala Journal: J Acquir Immune Defic Syndr Date: 2014-04-15 Impact factor: 3.731
Authors: C S de Kloet; E Vermetten; A Bikker; E Meulman; E Geuze; A Kavelaars; H G M Westenberg; C J Heijnen Journal: Mol Psychiatry Date: 2007-01-23 Impact factor: 15.992
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: Dan J Stein; Katie A McLaughlin; Karestan C Koenen; Lukoye Atwoli; Matthew J Friedman; Eric D Hill; Andreas Maercker; Maria Petukhova; Victoria Shahly; Mark van Ommeren; Jordi Alonso; Guilherme Borges; Giovanni de Girolamo; Peter de Jonge; Koen Demyttenaere; Silvia Florescu; Elie G Karam; Norito Kawakami; Herbert Matschinger; Michail Okoliyski; Jose Posada-Villa; Kate M Scott; Maria Carmen Viana; Ronald C Kessler Journal: Depress Anxiety Date: 2014-06 Impact factor: 6.505
Authors: Dima A Hammoud; Sanhita Sinharay; Sally Steinbach; Paul G Wakim; Katrina Geannopoulos; Katherine Traino; Amit K Dey; Edmund Tramont; Stanley I Rapoport; Joseph Snow; Nehal N Mehta; Bryan R Smith; Avindra Nath Journal: Neurology Date: 2018-09-26 Impact factor: 9.910
Authors: Eaden Andu; Brad H Wagenaar; Chris G Kemp; Paul E Nevin; Jane M Simoni; Michele Andrasik; Susan E Cohn; Audrey L French; Deepa Rao Journal: AIDS Care Date: 2018-04-26