Correlates of depression among US military members infected with the human immunodeficiency virus

International Conference on HIV/AIDS, STDs, & STIs

October 24-25, 2013 Holiday Inn Orlando International Airport, Orlando, FL, USA

Robert J. Carpenter

Accepted Abstracts: J AIDS Clin Res

Abstract :

T he objective is to define the incidence of mental health disorders (MHD) and risk factors associated with incident MHD in an HIV clinic setting with unrestricted access to care and limited confounding due to concomitant injection drug use (IDU). Eligible subjects were HIV positive adults followed at a US military treatment facility during the calendar year 2005. Incidence rates are calculated per 100 person years (py). Cox proportional hazards regression were utilized to identify risk factors associated with MHD. All persons not experiencing MHD were followed until study completion in January 2008. 494 subjects (51% Black, 93% male, median CD4 count 458) were followed for 5200 py. 160 subjects developed MHD for an overall incidence of 3.1/100 py of follow up. The incidence of depression and anxiety were 2.4/100 py and 0.4/100 py, respectively. Factors associated with a diagnosis of incident MHD include receipt of a protease inhibitor (PI) based regimen (HR 2.0, referent - no ART), non-Black ethnicity, and HIV diagnosis in the post HAART era; male gender was protective. In a cohort with limited confounding, incident MHD was common. Unlike prior studies, non-nucleoside reverse transcriptase inhibitor (NNRTI) use and MHD association was not observed; instead PI use was associated with MHD, perhaps due to PI enhanced mitochondrial toxicity, signaling need for further research. Given the significant burden of MHD observed in this cohort, mental health screening should be considered in the management of HIV infection

Biography :

Robert J. Carpenter, DO FACP, completed internal medicine residency at Walter Reed National Military Medical Center, M.D., and infectious diseases fellowship at Naval Medical Center San Diego, CA. He is board certified in internal medicine and infectious diseases and currently serves as head, HIV Section, Division of Infectious Diseases, Naval Medical Center, San Diego. He has served as an active duty US Naval officer for 13 years and specializes in HIV and STI medicine. Current active research projects of his include study of HPV-related anal dysplasia in HIV-infected men, neurosyphilis treatment in HIV-infected persons, and syphilis screening tests