The Association Between Post-traumatic Stress Disorder and Markers of Inflammation and Immune Activation in HIV-Infected Individuals With Controlled Viremia.
Post-traumatic stress disorder (PTSD) may be associated with chronic immune dysregulation and a proinflammatory state. Among HIV-infected individuals, PTSD is associated with greater morbidity and mortality, but the association with immune dysfunction has not been evaluated. This study explores the association between PTSD and selected markers of inflammation and immune activation in a cohort of HIV-infected, virally-suppressed individuals.



HIV-infected adults who were virologically controlled on antiretroviral medications were recruited through a screening protocol for studies of HIV-related neurocognitive disorders. Each participant underwent blood draws, urine toxicology screen, and completed the Client Diagnostic Questionnaire, a semistructured psychiatric interview.



Of 114 eligible volunteers, 72 (63%) were male, 77 (68%) African American, and 34 (30%) participants met criteria for PTSD. Participants with PTSD were more likely to be current smokers (79%) than those without (60%) (p = 0.05). The PTSD cohort had significantly higher total white blood cell counts (5318 and 6404 cells/uL, p = 0.03), absolute neutrophil count (2767 and 3577 cells/uL, p = 0.02), CD8% (43 and 48, p = 0.05), and memory CD8% (70 and 78%, p = 0.04); lower naïve CD8% (30 and 22%, p = 0.04) and higher rate of high-sensitivity C-reactive protein >3mg/L (29 and 20, p = 0.03).



A high prevalence of PTSD was identified in this cohort of HIV-infected adults who were virally suppressed. These results suggest that PTSD may be associated with immune dysregulation even among antiretroviral therapy-adherent HIV-infected individuals.
Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD. Electronic address: peterselim.siyahhanjulnes@nih.gov.
Peter
P
Siyahhan Julnes
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD.
Sungyoung
S
Auh
Critical Care Medicine Department, National Institutes of Health, Bethesda, MD.
Rebecca
R
Krakora
National Institute of Mental Health, National Institutes of Health, Bethesda, MD.
Keenan
K
Withers
National Institute of Mental Health, National Institutes of Health, Bethesda, MD.
Diana
D
Nora
Critical Care Medicine Department, National Institutes of Health, Bethesda, MD.
Lindsay
L
Matthews
Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Frederick National Laboratory for Cancer Research, Leidos Biomedical Research Inc, Frederick, MD.
Sally
S
Steinbach
National Institute of Mental Health, National Institutes of Health, Bethesda, MD.
Joseph
J
Snow
Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
Bryan
B
Smith
Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD.
Avindra
A
Nath
Critical Care Medicine Department, National Institutes of Health, Bethesda, MD.
Caryn
C
Morse
National Institute of Mental Health, National Institutes of Health, Bethesda, MD; Department of Psychiatry and The Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA.
Suad
S
Kapetanovic
D000328:Adult; D001741:Black or African American; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers; D002097:C-Reactive Protein / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000166:cytology / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology* / Q000523:psychology; D006801:Humans; D007249:Inflammation; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology / Q000276:immunology; D015995:Prevalence; D012907:Smoking / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000276:immunology* / Q000523:psychology; D011795:Surveys and Questionnaires; D019562:Viral Load; D044465:White People
D015415:Biomarkers; D002097:C-Reactive Protein
PLWH; antiretroviral therapy; client diagnostic questionnaire; immunophenotyping; mental health; post-traumatic stress