title: Differences in clinical and psychiatric outcomes between prevalent HIV-1 molecular subtypes in a multiethnic Southeast Asian sample.
abstract: OBJECTIVE
  In Southeast Asia, subtypes B and CRF01_AE are the prevalent human immunodeficiency virus-1 (HIV-1) subtypes. This study examines the intersubtype differences in clinical indicators and psychiatric symptoms in a multiethnic sample.
  
  
  METHODS
  The study site was a national HIV treatment center. Data were extracted from the Molecular Epidemiology Research study and the HIV-Psychiatry Integrated Mental Health Project, and analyzed according to groups defined by viral subtype.
  
  
  RESULTS
  Of 177 subjects, 54.8% were infected with subtype CRF01_AE; 42.9% screened positive on the Hospital Anxiety and Depression Scale (HADS). The CRF01_AE group was significantly older (mean 38.29 years vs. 34.62 years, P=.031) and had advanced immunosuppression (CD4 <200) just prior to HADS screening (33.0% vs. 13.5%, P=.003). By multivariate logistic regression, homosexual transmission [odds ratio (OR) 0.388, 95% confidence interval (CI) 0.158-0.951, P=.038], subtype CRF01_AE (OR 2.898, 95% CI 1.199-7.001, P=.018) and positive HADS screening (OR 2.859, 95% CI 1.261-8.484, P=.012) were associated with advanced immunosuppression; and only advanced immunosuppression was associated with screening positive on the HADS (OR 3.270, 95% CI 1.299-8.227, P=.012).
  
  
  CONCLUSIONS
  Subtype CRF01_AE is associated with advanced immunosuppression but not with symptoms of anxiety and depression. The results suggest that psychiatric symptoms are associated with advanced HIV disease regardless of subtype.
authors.affiliation: Department of Psychological Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433. Electronic address: lai_gwen_chan@ttsh.com.sg.
authors.forename: Lai Gwen
authors.initials: LG
authors.lastname: Chan
authors.affiliation: Department of Psychological Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433. Electronic address: hmeijing@gmail.com.
authors.forename: Mei Jing
authors.initials: MJ
authors.lastname: Ho
authors.affiliation: Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433. Electronic address: Palvinder_Kaur_Singh@ttsh.com.sg.
authors.forename: Palvinder
authors.initials: P
authors.lastname: Kaur
authors.affiliation: Department of Psychological Medicine, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433; Psychological Wellness Program, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433. Electronic address: Jaspal_Singh@ttsh.com.sg.
authors.forename: Jaspal
authors.initials: J
authors.lastname: Singh
authors.affiliation: Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433. Electronic address: Oon_Tek_NG@ttsh.com.sg.
authors.forename: Oon Tek
authors.initials: OT
authors.lastname: Ng
authors.affiliation: Institute of Infectious Disease and Epidemiology, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433; Yong Loo Lin School of Medicine, National University of Singapore, 11 Jalan Tan Tock Seng, Singapore, 308433. Electronic address: Cheng_Chuan_Lee@ttsh.com.sg.
authors.forename: Cheng Chuan
authors.initials: CC
authors.lastname: Lee
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, 11 Jalan Tan Tock Seng, Singapore, 308433; Communicable Disease Centre, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433; Lee Kong Chian School of Medicine, Nanyang Technological University, 11 Jalan Tan Tock Seng, Singapore, 308433; Saw Swee Hock School of Public Health, National University of Singapore, 11 Jalan Tan Tock Seng, Singapore, 308433. Electronic address: Yee_Sin_Leo@ttsh.com.sg.
authors.forename: Yee Sin
authors.initials: YS
authors.lastname: Leo
authors.affiliation: Medical Psychiatry Consultation Service, Department of Psychiatry, St Michael's Hospital, 20 Bond Street, Toronto, ON, M5B 1W8, Canada; Department of Psychiatry, University of Toronto, 20 Bond Street, Toronto, ON, M5B 1W8, Canada; Li Kah Shing, St Michael's Hospital, 20 Bond Street, Toronto, ON, M5B 1W8, Canada. Electronic address: CarvalhalA@smh.ca.
authors.forename: Adriana
authors.initials: A
authors.lastname: Carvalhal
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001007:Anxiety / Q000453:epidemiology* / Q000523:psychology; D001210:Asia, Southeastern / Q000453:epidemiology; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data; D018791:CD4 Lymphocyte Count; D003863:Depression / Q000453:epidemiology* / Q000523:psychology; D004522:Educational Status; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D020010:Heterosexuality / Q000706:statistics & numerical data; D006716:Homosexuality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D015995:Prevalence; D012846:Singapore / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D044465:White People / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult
keywords: AIDS; Anxiety; Depression; HIV; Psychiatry