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Psychosocial and Neurohormonal Predictors of HIV Disease Progression (CD4 Cells and Viral Load): A 4 Year Prospective Study

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Abstract

Most studies of psychosocial predictors of disease progression in HIV have not considered norepinephrine (NE), a neurohormone related to emotion and stress, even though NE has been related to accelerated viral replication in vitro and impaired response to antiretrovial therapy (ART). We therefore examined NE, cortisol, depression, hopelessness, coping, and life event stress as predictors of HIV progression in a diverse sample. Participants (n = 177) completed psychological assessment, blood draws [CD4, viral load (VL)], and a 15 h urine sample (NE, cortisol) every 6 months over 4 years. Hierarchical linear modeling (HLM) was used to model slope in CD4 and VL controlling for ART at every time point, gender, age, race, SES, and initial disease status. NE (as well as depression, hopelessness, and avoidant coping) significantly predicted a greater rate of decrease in CD4 and increase in VL. Cortisol was not significantly related to CD4, but predicted VL increase. To our knowledge, this is the first study relating NE, in vivo, to accelerated disease progression over an extended time. It also extends our previous 2 year study by relating depressed mood and coping to accelerated disease progression over 4 years.

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Acknowledgments

This research was graciously supported by the National Institute of Mental Health Grant (Grant numbers R01MH53791, R01MH066697), and the Action for AIDS Foundation (Grant number T32MH18917). Principal Investigator: Gail Ironson. We wish to thank our participants with HIV for their time and effort in making this analysis possible.

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Author notes

  1. C. O’Cleirigh

    Present address: Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA

Authors and Affiliations

  1. Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, Miami, FL, 33146, USA

    G. Ironson, C. O’Cleirigh, L. Kaplan, E. Balbin, C. B. Kelsch & N. Schneiderman

  2. Department of Psychiatry, University of Miami, Miami, FL, USA

    G. Ironson & N. Schneiderman

  3. Department of Medicine, University of Miami, Miami, FL, USA

    M. Kumar, M. A. Fletcher & N. Schneiderman

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  1. G. Ironson
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Correspondence to G. Ironson.

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Ironson, G., O’Cleirigh, C., Kumar, M. et al. Psychosocial and Neurohormonal Predictors of HIV Disease Progression (CD4 Cells and Viral Load): A 4 Year Prospective Study. AIDS Behav 19, 1388–1397 (2015). https://doi.org/10.1007/s10461-014-0877-x

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