Study on Effectiveness of Psychological Intervention for Depression in Newly Diagnosed HIV/AIDS-infected Patients and the Relationship with CD4+ T Cell Counts

Abstract

Background HIV/AIDS is associated with depression, which increases the risk of HIV-associated neurocognitive disorders (HAND) and reduces patient compliance with antiretroviral therapy (ART), exacerbating the risk of HIV transmission. Few domestic studies have reported on the effectiveness of psychological intervention for depressed patients of people living with HIV/AIDS (PLWHA) newly diagnosed and its correlation with CD4+ T cell counts. Objective To explore the effectiveness of psychological intervention for newly diagnosed PLWHA with depression and its correlation with CD4+ T cell counts, providing a reference for AIDS clinical diagnosis and treatment. Methods From April 2020 to June 2022, a convenient sampling method was used to select newly diagnosed PLWHA with depression from some ART-designated hospitals in Jiangxi Province. While they were diagnosed, ART and psychological intervention were immediately initiated, and the total period of intervention was 12 weeks. Before and after the intervention, the Hamilton Depression Rating Scale (HAMD) and Hamilton Anxiety Rating Scale (HAMA) were used for evaluation, and CD4+ T cell counts were calculated for analysis. Results A total of 200 newly diagnosed PLWHA with depression were included, 178 cases of which were effectively followed up with an effective rate of 89.0%. Among 178 cases, 88 were mild to moderate depression (49.4%), 90 were major depressive disorder (50.6%), and 173 cases were accompanied by anxiety (97.2%). The mean CD4+ T cell count before intervention was (346.39±156.87) cells/μL, and it was (421.93±149.61) cells/μL after intervention. After intervention, the CD4+ T cell counts of newly diagnosed PLWHA with depression were higher than before intervention (t=10.971, P<0.05), and the total and factor scores of HAMD, HAMA were all lower than before intervention (P<0.05). Before the intervention, the total scores of HAMD were correlated with the grades of CD4+ T cell counts negatively (500 cells/μL as the cutoff value) (rs=-0.157, P=0.036) and the scores of HAMA positively (rs=0.764, P<0.001). After the intervention, the total scores of HAMD were correlated with post-intervention CD4+ T cell counts negatively (rs=-0.150, P=0.046) and the total scores of HAMA strongly positively (rs=0.939, P<0.001). In newly diagnosed PLWHA with depression, the total scores of HAMD and HAMA of patients with CD4+ T cell counts <500 cells/μL were higher than those with CD4+ T cell counts≥500 cells/μL (P<0.05) before intervention. Conclusion The severity of depression in newly diagnosed PLWHA is associated with CD4+ T cell counts, which could be significantly improved by professional psychological intervention.

Keywords

• acquired immunodeficiency syndrome|hiv infections|cd4+ t cell counts|depression|anxiety