title: Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virus-infected men. A 2-year follow-up study.
abstract: BACKGROUND
  This study examined how severe stress and depressive symptoms were related to changes in immune measures during a 2-year period in a sample of gay men with human immunodeficiency virus (HIV) infection. These analyses follow up our initial cross-sectional observations that severe stress was correlated with lower levels of natural killer (NK) cells and CD8+ T lymphocytes in these men.
  
  
  METHODS
  Data were collected in North Carolina as part of an ongoing, longitudinal study, the Coping in Health and Illness Project. Sixty-six HIV-infected gay men, who were asymptomatic at baseline, were assessed systematically at 6-month intervals.
  
  
  RESULTS
  Severe stress and depressive symptoms were independently related to decreases on immune measures from entry to 2-year follow-up, that is, declines in CD8+ T cells and CD56+ and CD16+ NK cell subsets. Subjects most likely to have decreases on these immune measures were those who scored above the median on both stress and depressive symptoms.
  
  
  CONCLUSIONS
  Our findings are among the first prospective data showing that stress and depressive symptoms, especially when they occur jointly, are associated with decreased number of NK and CD8+ T lymphocytes in HIV-infected men. Since these immune cells may play a protective role in the progression of HIV infection, our data suggest that stress and depressive symptoms may have clinical implications for the course of this disease.
authors.affiliation: Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, USA.
authors.forename: J
authors.initials: J
authors.lastname: Leserman
authors.forename: J M
authors.initials: JM
authors.lastname: Petitto
authors.forename: D O
authors.initials: DO
authors.lastname: Perkins
authors.forename: J D
authors.initials: JD
authors.lastname: Folds
authors.forename: R N
authors.initials: RN
authors.lastname: Golden
authors.forename: D L
authors.initials: DL
authors.lastname: Evans
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology; D015897:Comorbidity; D003866:Depressive Disorder / Q000453:epidemiology* / Q000276:immunology; D005434:Flow Cytometry; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology*; D018451:Homosexuality, Male; D006801:Humans; D007694:Killer Cells, Natural / Q000276:immunology; D008016:Life Change Events; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016176:T-Lymphocyte Subsets / Q000276:immunology