"Treatment of mood disorders may be important for promoting sustained viral suppression," the authors of a study among 5,904 participants in Washington, D.C., concluded in Journal of Acquired Immune Deficiency Syndromes.
Data came from the electronic medical records of an observational cohort of PLWH (more than 80% African American, and 70% cisgender men). Overall, 45% of participants were diagnosed with at least one psychiatric disorder at some point during the study. Participants who had been diagnosed with depressive or bipolar disorders spent more time with viral loads ≥ 200 copies/mL than those without mood disorders. That association was even stronger when the psychiatric condition was not treated with prescription medications, suggesting that pharmacological treatment of depressive or bipolar disorders improved a person's ability to maintain viral suppression.
The percentages of people who received a pharmacologic prescription for their psychiatric disorder varied within the study, from a high of 64% among people with disorders related to anxiety, stress, or trauma to a low of 50% among people diagnosed with a mood disorder. However, researchers cautioned that data were not available regarding mental health prescriptions a participant may have received elsewhere, or cases in which psychotherapy without medications was successful.
Curiously, participants who were diagnosed with an anxiety disorder spent less overall time with a viral load at or above 200 compared to participants without an anxiety disorder. Psychopharmacological medications heightened that association, suggesting that in some cases, untreated but manageable anxiety led to a greater attention to antiretroviral adherence, according to the study authors.
"Taken together, these findings reinforce that the appropriate diagnosis, treatment, and monitoring of psychiatric disorders, particularly for depressive and bipolar disorders, are critical for promoting sustained viral suppression among PLWH with comorbid psychiatric disorders," study authors concluded.