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Comparative effectiveness of dual vs. single-action antidepressants on HIV clinical outcomes in HIV-infected people with depression.

Title: Comparative effectiveness of dual vs. single-action antidepressants on HIV clinical outcomes in HIV-infected people with depression.
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Name(s): Mills, Jon C, author
Harman, Jeffrey S, author
Cook, Robert L, author
Marlow, Nicole M, author
Harle, Christopher A, author
Duncan, R Paul, author
Gaynes, Bradley N, author
Pence, Brian W, author
Type of Resource: text
Genre: Journal Article
Text
Date Issued: 2017-11-28
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: Depression is highly prevalent among people living with HIV/AIDS (PLWHA) and has deleterious effects on HIV clinical outcomes. We examined changes in depression symptoms, viral suppression, and CD4 T cells/μl among PLWHA diagnosed with depression who initiated antidepressant treatment during routine care, and compared the effectiveness of dual-action and single-action antidepressants for improving those outcomes. Comparative effectiveness study of new user dual-action or single-action antidepressant treatment episodes occurring from 2004 to 2014 obtained from the Center for AIDS Research Network of Integrated Clinical Systems. We identified new user treatment episodes with no antidepressant use in the preceding 90 days. We completed intent-to-treat and per protocol evaluations for the main analysis. Primary outcomes, were viral suppression (HIV viral load <200 copies/ml) and CD4 T cells/μl. In a secondary analysis, we used the Patient Health Questionnaire-9 (PHQ-9) to evaluate changes in depression symptoms and remission (PHQ <5). Generalized estimating equations with inverse probability of treatment weights were fitted to estimate treatment effects. In weighted intent-to-treat analyses, the probability of viral suppression increased 16% after initiating antidepressants [95% confidence interval = (1.12, 1.20)]. We observed an increase of 39 CD4T cells/μl after initiating antidepressants (30, 48). Both the frequency of remission from depression and PHQ-9 scores improved after antidepressant initiation. Comparative effectiveness estimates were null in all models. Initiating antidepressant treatment was associated with improvements in depression, viral suppression, and CD4 T cells/μl, highlighting the health benefits of treating depression in PLWHA. Dual and single-action antidepressants had comparable effectiveness.
Identifier: FSU_pmch_28832409 (IID), 10.1097/QAD.0000000000001618 (DOI), PMC5680130 (PMCID), 28832409 (RID), 28832409 (EID)
Grant Number: R01 MH100970, P30 AI027767, T32 AI007001, P30 AI094189, U01 DA036935, R24 AI067039, P30 AI027763, P30 AI036214, P30 AI027757, P30 AI060354, P30 AI036219, P30 AI050410
Publication Note: This NIH-funded author manuscript originally appeared in PubMed Central at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680130.
Subject(s): Adult
Antidepressive Agents/therapeutic use
CD4 Lymphocyte Count
Depression/drug therapy
Female
HIV Infections/complications
HIV Infections/pathology
Humans
Male
Middle Aged
Neuropsychological Tests
Surveys and Questionnaires
Sustained Virologic Response
Treatment Outcome
Viral Load
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_pmch_28832409
Owner Institution: FSU
Is Part Of: AIDS (London, England).
1473-5571
Issue: iss. 18, vol. 31

Choose the citation style.
Mills, J. C., Harman, J. S., Cook, R. L., Marlow, N. M., Harle, C. A., Duncan, R. P., … Pence, B. W. (2017). Comparative effectiveness of dual vs. single-action antidepressants on HIV clinical outcomes in HIV-infected people with depression. Aids (London, England). Retrieved from http://purl.flvc.org/fsu/fd/FSU_pmch_28832409