title: Bereavement is associated with time-dependent decrements in cellular immune function in asymptomatic human immunodeficiency virus type 1-seropositive homosexual men.
abstract: Seventy-nine human immunodeficiency virus type 1 (HIV-1)-seropositive homosexual men participating in a longitudinal study of HIV-1 infection were assessed twice, 6 months apart, to investigate associations between bereavement and cellular immune function. Subjects were assessed by using a theory-driven model comprising life stressors, social support and coping style, and control variables. Natural killer cell cytotoxicity was decreased among the bereaved at both times. Lymphocyte proliferative response to phytohemagglutinin was decreased among the bereaved at the second time point but not at the first. These functional immune decrements are associated with increased neuroendocrine responses of the sympathetic adrenomeduallary system as well as the limbic-hypothalamic-pituitary-adrenal axis. Implications for differential neuroendocrine responses over time are discussed. Active coping style was independently and positively related to both immune measures. The results imply that a bereavement support group intervention merits investigation for an effect on immunological measures and clinical progression of HIV-1 infection as well as grief resolution.
authors.affiliation: Department of Psychiatry, University of Miami School of Medicine, Florida 33136-1045, USA. kgoodkin@mednet.med.miami.edu
authors.forename: K
authors.initials: K
authors.lastname: Goodkin
authors.forename: D J
authors.initials: DJ
authors.lastname: Feaster
authors.forename: R
authors.initials: R
authors.lastname: Tuttle
authors.forename: N T
authors.initials: NT
authors.lastname: Blaney
authors.forename: M
authors.initials: M
authors.lastname: Kumar
authors.forename: M K
authors.initials: MK
authors.lastname: Baum
authors.forename: P
authors.initials: P
authors.lastname: Shapshak
authors.forename: M A
authors.initials: MA
authors.lastname: Fletcher
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001601:Bereavement; D006117:Grief; D006679:HIV Seropositivity / Q000276:immunology* / Q000523:psychology*; D015497:HIV-1; D018451:Homosexuality, Male; D006801:Humans; D007111:Immunity, Cellular; D066298:In Vitro Techniques; D007694:Killer Cells, Natural / Q000276:immunology; D008137:Longitudinal Studies; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009490:Neurosecretory Systems / Q000276:immunology; D012944:Social Support