Infectious Disease ·
HIV-related stress trajectories associated with CD4/CD8 ratio normalization
A nine-year cohort study in Changsha, China, followed 338 adults with HIV and examined whether psychosocial trajectories were associated with CD4/CD8 ratio normalization after ART initiation. Some stress trajectories were associated with different rates of normalization, though the findings do not establish that stress caused these differences.
- Cohort followed adults with HIV for nine years in Changsha.
- Eighty-eight of 338 participants reached a CD4/CD8 ratio of at least 1.
- Social and emotional stress trajectories showed differing associations with normalization.
- Observational associations do not establish causation.
This longitudinal cohort study included adults newly diagnosed with HIV in Changsha, China, in 2013–2014. Participants completed psychosocial assessments at baseline and approximately 1, 5, and 9 years after diagnosis. The primary analysis included 338 people who completed at least three assessments and met clinical eligibility criteria. Investigators used latent growth mixture models to identify psychosocial trajectories and Cox regression to assess time to first recorded CD4/CD8 ratio of at least 1.0 after ART initiation; a five-year landmark analysis was also performed.
Overall, 88 participants (26.0%) reached the ratio threshold. In adjusted analyses, a persistently high social stress trajectory was associated with a lower hazard of normalization than a persistently low trajectory (adjusted hazard ratio [aHR], 0.562; 95% CI, 0.321–0.985). A U-shaped emotional stress trajectory was associated with a higher hazard than a persistently low trajectory (aHR, 2.135; 95% CI, 1.064–4.283). In the landmark analysis, the social stress association remained, while the confidence interval for emotional stress included 1.
These observational findings link psychosocial patterns with an immune recovery marker but do not show causation. The authors suggest repeated assessment of HIV-related stress may complement routine monitoring; the study does not establish that stress interventions improve CD4/CD8 ratio normalization.
In practice
Among adults newly diagnosed with HIV in Changsha, psychosocial stress trajectories were associated with time to CD4/CD8 ratio normalization after ART initiation. The study supports considering psychosocial stress as a potential complement to immune-recovery assessment, but it does not show that stress causes poorer or faster normalization or that interventions improve this outcome. The cohort was observational, included 338 participants with repeated assessments, and the emotional-stress association was less robust in the landmark analysis; these findings alone do not justify changing ART or monitoring practices.
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BMC Public Health: Psychosocial trajectories and CD4+/CD8+ ratio normalization among adults with HIV in Changsha, China: a 9-year longitudinal cohort study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.