Abstract
•Depressive symptoms predicted changes in inflammation and immune activation over one year among men with HIV in Brazil.•Depression and alcohol use showed high within-person variability across time; stimulant use was mostly stable.•Studies should investigate if interventions targeting depression can improve immune function among men with HIV in Brazil.
Limited research has examined the longitudinal interplay of depression, substance use, and immune dysregulation among men with HIV.
We analyzed longitudinal data from 100 men who have sex with men (MSM) living with HIV enrolled in the HPTN 063 cohort (2011–2013) in Brazil. Depressive symptom severity, alcohol use severity, and recent illicit stimulant use were assessed quarterly over 12 months. Soluble markers of immune activation (sCD14) and inflammation (IL-6) were measured at baseline and at a 12-month visit.
Depressive symptom severity and alcohol use severity showed substantial within-person variability across time, whereas stimulant use remained relatively stable. These psychosocial factors were weakly intercorrelated. Controlling for baseline IL-6, the odds of having detectable IL-6 at 12 months increased by 2 % for each point increase in the proportion of visits with elevated depression, 7 % for each point increase in mean depressive severity across visits, 5 % for each point increase in depressive severity at nine months, and 6 % for each point increase in depressive severity at 12 months. Effects persisted after controlling for baseline HIV viral load. Controlling for baseline sCD14, estimated 12-month sCD14 increased 8 ng/mL for each point increase in 12-month depressive severity and 20 ng/mL for each point increase in 12-month alcohol use severity. The alcohol–sCD14 association was attenuated when adjusting for HIV viral load. Neither baseline IL-6 nor sCD14 strongly predicted future depressive symptoms or substance use.
Depressive symptoms predicted future inflammation and current immune activation. Research should examine if interventions to treat depression can improve immune functioning.