Why Treating Major Depressive Disorder Improves Outcomes in HIV

published on May 11, 2018 by Suzanne Bujara, in Psychiatry Advisor

Despite the prevalence of depression in people with HIV (estimates of up to 42%), few data exist on antidepressant efficacy in this population.¹ Previous studies of depression in people with HIV have tended to be from American men who have sex with men. As a result, clinicians still are unclear about how antidepressants affect both men and women with HIV, and which agents are effective and work well with antiretroviral therapy (ART).

Although a recent global meta-analysis of 10 studies and 709 participants found antidepressants to be beneficial to people with HIV and depression, it could not definitively advise which specific antidepressants were most effective.¹ Most of the studies were from the United States, and 7 of the studies had mostly male participants. Only 3 of the 10 studies compared different classes of antidepressants, so clinicians still do not know whether selective serotonin reuptake inhibitors are more effective than tricyclic antidepressants. Moreover, the studies did not assess the effect depression therapy had on patients' virologic suppression.

"Now that ART is being provided early during HIV infection, it would follow that HIV-positive people suffering from depression are similar to HIV-negative people with depression in the same setting," noted lead author Ingrid Eshun-Wilson, MBChB, MSc, an epidemiologist from Stellenbosch University in Cape Town, South Africa, in an interview with Infectious Disease Advisor.

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BC Centre for Excellence in HIV/AIDS

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Why Treating Major Depressive Disorder Improves Outcomes in HIV

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