Psychiatric Disorders in AIDS Patients Do Not Affect the Initiation  and Duration of Therapy

Psychiatric disorders are common in HIV patients, and previous work suggests that these patients experience delays in treatment with HAART.

In the present study, researchers investigated whether a current psychiatric disorder (1) affected the time to initiation of HAART, (2) predicted the likelihood of being prescribed HAART for at least 6 months, and (3) affected survival in urban AIDS patients.

The investigators conducted a retrospective cohort study of AIDS patients with no prior history of HAART who were enrolled and followed at the Johns Hopkins University HIV clinic between January 1996 and January 2002.

Patients were stratified based on the presence of a psychiatric disorder. Cox proportional hazards regression models estimated the relative risk of receiving HAART and survival, whereas multivariate logistic regression models estimated the relative odds of remaining on HAART.

Results

During the study period, 549 patients with AIDS and no prior antiretroviral treatment were enrolled in the clinic. Eighteen percent (n = 100) were defined as having a current psychiatric disorder, 39% (n = 215) were defined as having no psychiatric disorder, and 43% (n = 34) were indeterminate.

Patients with a psychiatric disorder were 37% more likely to receive HAART, had greater than twice the odds of being prescribed HAART for at least 6 months, and were 40% more likely to survive as compared with those without a psychiatric disorder.

The authors conclude, “Patients with psychiatric disorders are receiving HAART and are able to reap the survival benefit by remaining on it.”

11/24/04

Reference
S Himelhoch and others. Does the Presence of a Current Psychiatric Disorder in AIDS Patients Affect the Initiation of Antiretroviral Treatment and Duration of Therapy? Journal of Acquired Immune Deficiency Syndromes. 37(4): 1457-1463. December 1, 2004.