title: Psychological distress and physical pain appear to have no short-term adverse impact on plasma HIV-1 RNA levels in patients on successful HAART.
abstract: OBJECTIVE
  Previous studies have linked depression and stressful life events in HIV disease with a more rapid decline in CD4 count and progression to AIDS. However, the short-term effect of psychological and physical distress on HIV-1 RNA levels in patients on successful HAART has not been well studied.
  
  
  METHODS
  Ten asymptomatic HIV-infected adults with suppression of viremia to <50 copies/mL on a stable HAART regimen for > or =6 months were studied. Participants donated blood every 2-3 days over a 3-4 month period for duplicate independent viral load measurements and drug level monitoring. At each time point, psychological distress was measured using the Mental Health Inventory-5 (MHI-5) and an 11-point numeric rating scale for emotional stress. Physical pain was assessed using an 11-point numeric rating scale.
  
  
  RESULTS
  All patients maintained successful viral suppression throughout the study. Twenty-six of 713 (3.6%) viral load measurements were >50 copies/mL. Psychological distress and physical pain were not associated with episodes of detectable viremia.
  
  
  CONCLUSIONS
  Using frequent monitoring of HIV-1 RNA levels and patient ratings of mood, stress, and pain, we found that psychological distress and physical pain had no short-term adverse impact on HIV-1 RNA levels in highly adherent patients with stable suppression of viremia on HAART.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 08543, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Nettles
authors.forename: Tara L
authors.initials: TL
authors.lastname: Keiffer
authors.forename: Joseph
authors.initials: J
authors.lastname: Cofrancesco
authors.forename: Joel E
authors.initials: JE
authors.lastname: Gallant
authors.forename: Thomas
authors.initials: T
authors.lastname: Quinn
authors.forename: Brooks
authors.initials: B
authors.lastname: Jackson
authors.forename: Charles
authors.initials: C
authors.lastname: Flexner
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Carson
authors.forename: Albert W
authors.initials: AW
authors.lastname: Wu
authors.forename: Robert F
authors.initials: RF
authors.lastname: Siliciano
mesh_terms: D000328:Adult; D000339:Affect; D019380:Anti-HIV Agents / Q000097:blood / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D003863:Depression / Q000150:complications*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D012367:RNA, Viral / Q000097:blood; D013315:Stress, Psychological / Q000150:complications*; D011795:Surveys and Questionnaires; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral