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Effectiveness of Mindfulness-Based Cognitive Therapy on the Quality of Life, Emotional Status, and CD4 Cell Count of Patients Aging with HIV Infection

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Abstract

Long-term diagnosed and treated HIV-infected patients have to cope with a wide range of challenges that threaten their ability to age successfully. We report the results of a randomized controlled trial testing the effects of a mindfulness-based cognitive therapy (MBCT) program on quality of life (QoL), emotional status, and immune status over a 3-month period. Forty HIV-infected patients diagnosed prior to 1996 and on cART for a minimum of 5 years were randomized to follow an MBCT program (n = 20) or remain as controls (routine follow-up) (n = 20). A regression analysis was performed, and the measurement of effect size was estimated using Cohen’s d. QoL, psychological stress, depressive symptoms, and anxiety symptoms improved in the MBCT group compared with the control group. During follow-up, patients in the MBCT group had a significantly increased CD4 cell count. Effect sizes for MBCT on the variables assessed were large (d = 0.8). The findings suggest that this program may help to promote successful aging in these patients.

Resumen

Los pacientes infectados por el VIH largamente diagnosticados y tratados han de afrontar desafíos que amenazan su capacidad para envejecer de forma exitosa. Mostramos los resultados de un estudio controlado aleatorizado que evalúa los efectos de un programa de terapia cognitiva basada en la atención plena (MBCT) sobre la calidad de vida, estado emocional y estado inmunológico en un período de tres meses. Cuarenta pacientes infectados por el VIH diagnosticados antes de 1996 y en terapia antirretroviral combinada durante un mínimo de 5 años fueron aleatorizados a seguir un programa MBCT (n = 20) o permanecer como controles (seguimiento rutinario) (n = 20). Se llevó a cabo un análisis de regresión y la medida del tamaño del efecto se estimó usando la d de Cohen. La calidad de vida, el estrés psicológico y los síntomas de depresión y ansiedad mejoraron en el grupo MBCT al compararlo con el grupo control. Durante el seguimiento, los pacientes del grupo MBCT tuvieron un incremento significativo en su recuento de células CD4. El tamaño del efecto de la intervención MBCT en todas las variables evaluadas fue grande (d = 0.8). Estos hallazgos sugieren que este programa puede ayudar a promover un envejecimiento exitoso en estos pacientes.

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Correspondence to Carmina R. Fumaz.

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Gonzalez-Garcia, M., Ferrer, M.J., Borras, X. et al. Effectiveness of Mindfulness-Based Cognitive Therapy on the Quality of Life, Emotional Status, and CD4 Cell Count of Patients Aging with HIV Infection. AIDS Behav 18, 676–685 (2014). https://doi.org/10.1007/s10461-013-0612-z

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