Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The health of informal caregivers is often studied from the perspective of caregivers' and care receivers' personal and interpersonal characteristics. This study offers an alternative explanation based on a vulnerable populations framework and considers the role of resource availability to the health status of informal caregivers (n=76). Caregivers in a convenience sample were females of diverse ethnicity and socioeconomic status, and care recipients were diagnosed with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) or age-related dementias (ARD). Personal interviews using structured instruments were conducted with caregivers who were attending outpatient clinics at a public hospital and a VA hospital. Instruments included the Center for Epidemiologic Studies Depression-Scale (CES-D), the Global Health Assessment (GHA), the Activities of Daily Living Scale (ADL), the Memory and Behavior Problems Checklist (MBPC) and items from the Symptom Checklist-90 (SCL-90) measuring anger, anxiety and loneliness. Caregivers were experiencing both physical and mental health problems. Regression analyses were used to examine the relationships among resources available to caregivers, conditions that put caregivers at risk for poorer health, and health status itself. Analyses were conducted for each group of caregivers separately (HIV and ARD) and for the total group, using depressive symptoms and perception of physical health as dependent variables. In caregivers of people with HIV/AIDS (PWHIV), caregiver distress over care recipient symptoms, anxiety and education were related to depressive symptoms. Depressive symptoms, anger and functional status of the PWHIV were related to caregivers' perception of poorer physical health. In caregivers of people with ARD, there were no significant predictors for depressive symptoms or perception of physical health. In the total group of caregivers, lower income and more anger were related to depressive symptom score. When perception of physical health was the dependent variable, minority ethnicity and depressive mood were related to worse perception of physical health. These findings support the relationship of a lack of resources to health status. A community-based programme of resources and health care services for the caregiver-care receiver dyad is recommended.
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PMID:Vulnerability to health problems in female informal caregivers of persons with HIV/AIDS and age-related dementias. 1115 9

This article examines the physical and mental health of African American mothers during a 2-year period following the birth of an infant seropositive for human immunodeficiency virus (HIV). Participants were 34 African American mothers enrolled when the infants were approximately 3 months of age and reinterviewed when the infants were 6, 12, 18, and 24 months. Three self-report questionnaires were used to assess physical health (perception of health, activity limitation, and physical symptoms) and mental health (depressive symptoms and stigma). Health symptoms most often reported were infections, problems thinking and remembering, low energy, and gynecologic problems. Moderate levels of perceived stigma were reported. Depressive symptoms were high; a large number of women at each data point had depressive symptom scores above the cutoff, indicating risk for depression. There were significant correlations between depressive symptoms and health, suggesting a link between mental and physical health. These findings have significance for the health of the mother and the parenting of her infant. Attention should be paid to the mental and physical health of mothers with HIV, especially during the first 2 years after the birth of a child.
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PMID:Physical and mental health in African American mothers with HIV. 1148 19

The prevalence of depression is high among injection drug users (IDUs) and among those infected with the hepatitis C virus (HCV). Moreover, one of the drugs used in the standard treatment for HCV infection (interferon) has been known to exacerbate underlying psychiatric disorders such as depression and has been associated with the development of major depressive disorder among HCV-infected patients. For these reasons, the most recent National Institutes of Health consensus statement on the management of HCV infection recommends the identification and treatment of depression prior to the start of HCV treatment. This study aimed to examine the extent of current moderate/severe depressive symptoms in a cohort of HCV-infected IDUs as measured by two screening tools, the Center for Epidemiologic Studies Depression Scale (CES-D) and the Beck Depression Inventory (BDI). Subjects were participants in a multisite behavioral intervention trial among HCV-seropositive, human immunodeficiency virus-negative IDUs aged 18-35 years; the trial was designed to prevent secondary transmission of HCV and to enhance uptake of HCV treatment. Baseline data on demographics, risk behaviors, depression, alcohol use, and health care utilization were measured via audio computer-assisted self-interview. A factor analysis was conducted on each scale to examine the clustering of items used in each to measure depressive symptoms. Baseline depressive symptoms, as measured via the CES-D and the BDI, were also compared using Pearson's correlation coefficient. Of 193 HCV-infected individuals enrolled to date, 75.6% were male, and 65.3% were white. Median age was 25.8 years. Factor analyses revealed that these scales measured depression differently; a distinct somatic component was present in the BDI, but not the CES-D. Using cutoff scores of 23 for the CES-D and 19 for the BDI, 44.0% and 41.5% of the participants were identified as having moderate/severe depressive symptoms, respectively. Over half (56.0%) were identified as having depressive symptoms by either scale. However, there was only moderate agreement between the two scales (kappa=0.46). Depressive symptoms were highly prevalent in this cohort of HCV-infected IDUs. Results indicated that both scales should be used in tandem to have the most sensitive detection of depressive symptoms, thereby maximizing the potential for HCV treatment success.
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PMID:Screening for depressive symptoms among HCV-infected injection drug users: examination of the utility of the CES-D and the Beck Depression Inventory. 1513 61

Acquired immune deficiency syndrome (AIDS) remains a leading cause of death for African-American women from 25 to 34 years of age. Depressive symptoms are commonly associated with the diagnosis of AIDS. Highly active antiretroviral therapy (HAART) is needed for optimal treatment; however, African-American women who are infected with the human immunodeficiency virus (HIV) and who experience depressive symptoms have low and/or inconsistent use of HAART. Additionally, behaviors associated with untreated depressive symptoms increase the chances for HIV transmission. Clinicians, therefore, need to recognize both the individual and the contextual factors that influence those seeking treatment for depressive symptoms. The purpose of this article is to gain a better understanding of the factors that shape treatment seeking for depressive symptoms among HIV-positive African-American women, an important variable in secondary HIV prevention. Multi-contextual underpinnings shape this phenomenon; therefore, Bronfenbrenner's ecological framework was used to organize this literature review. Knowledge gained from this paper can support the promotion of health and can prevent or manage depressive symptoms among this vulnerable group.
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PMID:Factors that shape mental health treatment-seeking behaviors of HIV-positive African-American women with depressive symptoms: a review of the literature. 1939 54

Human immunodeficiency virus (HIV) has a high comorbidity with major depression. Symptoms of depression may be attributed to ongoing HIV infection, thereby reducing the likelihood of timely treatment with antidepressants. This may contribute to the morbidity of both illnesses. This review focuses on an evidence-based approach to selecting antidepressants for first-line treatment of major depressive disorder in patients with HIV and acquired immune deficiency syndrome (AIDS). Some antidepressant medications have side effect profiles that may exacerbate the symptoms commonly seen in patients with HIV and AIDS. Others have side effects that, while normally problematic in the general population, may be helpful in counteracting the difficulties seen in HIV and AIDS patients. Other challenges in treatment include an array of possible drug-drug interactions between antidepressants and HIV medications. Clinicians should focus more on capitalizing on the side effects of psychotropic medications in this patient population than on trying to avoid drug-drug interactions.
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PMID:Choosing Antidepressants for HIV and AIDS Patients: Insights on Safety and Side Effects. 1972 53

This study examined psychological functioning and beliefs about medicine in adolescents with human immunodeficiency virus (HIV) on highly active antiretroviral therapy in a community-based directly observed therapy (DOT) pilot feasibility study. Participants were youth with behaviorally acquired HIV (n = 20; 65% female; median age, 21 years) with adherence problems, who received once-daily DOT. Youth were assessed at baseline, week 12 (post-DOT), and week 24 (follow-up). At baseline, 55% of youth reported having clinical depressive symptoms compared to 27% at week 12 with sustained improvements at week 24. At baseline, substance use was reported within the borderline clinical range (T(score) = 68), with clinical but statistically nonsignificant improvement (T(score) = 61) at week 12. Hopelessness scores reflected optimism for the future. Coping strategies showed significantly decreased cognitive avoidance (p = .02), emotional discharge (p = .004), and acceptance/resignation ("nothing I can do," p = .004), whereas positive reappraisal and seeking support emerged. With the exception of depressive symptoms, week 12 improvements were not sustained at week 24. DOT adherence was predicted by higher baseline depression (p = .05), beliefs about medicine (p = .006) and perceived threat of illness scores (p = .03). Youth with behaviorally acquired HIV and adherence problems who participated in a community-based DOT intervention reported clinically improved depressive symptoms, and temporarily reduced substance use and negative coping strategies. Depressive symptoms, beliefs about medicine, and viewing HIV as a potential threat predicted better DOT adherence.
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PMID:Psychological factors, beliefs about medication, and adherence of youth with human immunodeficiency virus in a multisite directly observed therapy pilot study. 2157 27

BACKGROUND: The frequency of neurocognitive impairment (NCI) in human immunodeficiency virus (HIV)-infected individuals remains high despite the availability of potent antiretroviral therapy (ART). The concurrence of depression among HIV-infected patients with NCI is common, especially among older individuals. Depression has been implicated as a risk factor for impaired neuropsychological performance (NP). This study explored the relationship between depressive symptoms and NP testing in HIV-infected individuals. METHODS: A cross-sectional analysis was performed within the Hawaii Aging with HIV Cohort, a large prospective study of cognition of older (50 or more years old) compared to younger (20 to 39 years old) HIV-infected individuals. RESULTS: Two hundred and eighty-five HIV infected participants (157 older and 128 younger) were administered a battery of NP tests to measure performance in major cognitive domains. Depressive symptoms were measured using the Beck Depression Inventory (BDI). The rates of depressive symptoms and neuropsychological impairment were similar in older and younger groups. Multivariate analyses revealed depressive symptoms were associated with NP test impairment in the younger group. In the older group, depressive symptoms were not associated with NP. CONCLUSION: This study suggests that depressive symptoms are associated with NP test impairment in younger HIV-infected individuals, but not in older individuals.
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PMID:The Impact of Depressive Symptoms on Neuropsychological Performance Tests in HIV-Infected Individuals: A Study of the Hawaii Aging with HIV Cohort. 2306 Oct 29

Based on the existing empirical evidence that psychosocial variables may predict the course of human immunodeficiency virus (HIV) illness, disease progression (described by advance in symptoms, decline in CD4+ cell count, and mortality) in 414 HIV-positive (HIV+) males was studied using Cox Proportional Hazards Models (survival analysis). Depressive symptoms predicted shorter longevity after controlling for symptoms and CD4+ cell count. Large social network sizes predicted longevity among those with acquired immune deficiency syndrome (AIDS)-defining symptoms at baseline, but not among other subjects. Therefore, psychosocial variables and affective states may be related to disease outcome only during later stages of HIV disease. Although the results provide support for psychoneuroimmunologic effects in HIV, other confounding explanations may still apply.
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PMID:Relationship of psychosocial factors to HIV disease progression. 2420 41

Depressive symptoms and fatigue are prevalent among people living with human immunodeficiency virus. Resistance exercise is known to stimulate a positive affective response.
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PMID:Acute Effects of Resistance-Exercise Intensity in Depressed Black/African Americans Living With HIV: A Randomized Pilot Study. 3138 82