Associations of Total, Cognitive/Affective, and Somatic Depressive Symptoms and Antidepressant Use With Cardiovascular Disease–Relevant Biomarkers in HIV

Veterans Aging Cohort Study

Bibliographic Data

ID19306192
AuthorsJohn C Stewart (0000-0001-7377-8823, Indiana University – Purdue University Indianapolis, corresponding author), Jesse C Stewart, Brittanny M Polanka (0000-0002-6422-6303), Kaku So-Armah (0000-0003-1505-6384), Kaku A So-Armah, Jessica White (0000-0002-7572-5044), Jessica R White (0000-0001-5802-4062), Samir K Gupta (0000-0001-6031-8705), Suman Kundu (0000-0002-6305-2559), Chung-Chou H Chang (0000-0001-8719-2508), Matthew S Freiberg (0000-0002-3699-4022)
Year2020
Volume82
Issue5
Pages461-470
Publication date2020-06-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenuePsychosomatic Medicine (JOURNAL)
Journal identifiersISSN: 0033-3174 • E-ISSN: 1534-7796
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/psy.0000000000000808
PMID32282648
OpenAlexW3015753252
LanguageEN
Citations received4
References cited53

OBJECTIVE: We sought to determine the associations of total, cognitive/affective, and somatic depressive symptoms and antidepressant use with biomarkers of processes implicated in cardiovascular disease in HIV (HIV-CVD). METHODS: We examined data from 1546 HIV-positive and 843 HIV-negative veterans. Depressive symptoms were assessed using the Patient Health Questionnaire-9, and past-year antidepressant use was determined from Veterans Affair pharmacy records. Monocyte (soluble CD14 [sCD14]), inflammatory (interleukin-6 [IL-6]), and coagulation (D-dimer) marker levels were determined from previously banked blood specimens. Linear regression models with multiple imputation were run to estimate the associations between depression-related factors and CVD-relevant biomarkers. RESULTS: Among HIV-positive participants, greater somatic depressive symptoms were associated with higher sCD14 (exp[b] = 1.02, 95% confidence interval [CI] = 1.00-1.03) and D-dimer (exp[b] = 1.06, 95% CI = 1.00-1.11) after adjustment for demographics and potential confounders. Further adjustment for antidepressant use and HIV factors slightly attenuated these relationships. Associations were also detected for antidepressant use, as selective serotonin reuptake inhibitor use was related to lower sCD14 (exp[b] = 0.95, 95% CI = 0.91-1.00) and IL-6 (exp[b] = 0.86, 95% CI = 0.76-0.96), and tricyclic antidepressant use was related to higher sCD14 (exp[b] = 1.07, 95% CI = 1.03-1.12) and IL-6 (exp[b] = 1.14, 95% CI = 1.02-1.28). Among HIV-negative participants, total, cognitive/affective, and somatic depressive symptoms were associated with higher IL-6, and tricyclic antidepressant use was related to higher sCD14. CONCLUSIONS: Our novel findings suggest that a) monocyte activation and altered coagulation may represent two pathways through which depression increases HIV-CVD risk and that b) tricyclic antidepressants may elevate and selective serotonin reuptake inhibitors may attenuate HIV-CVD risk by influencing monocyte and inflammatory activation

Antidepressant · Anxiety · Depression (economics) · Psychiatry · Cardiac Health and Mental Health · HIV-related health complications and treatments · Internal Medicine · Medicine · Tryptophan and brain disorders