The association between mental health and metabolic outcomes in youth living with perinatally acquired HIV in the Cape Town Adolescent Antiretroviral Cohort.

Journal: AIDS care

Volume: 34

Issue: 9

Year of Publication: 2022

Affiliated Institutions:  Department of Paediatrics & Child Health, Red Cross War Memorial Children's Hospital, and SA MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa. Department of Pediatrics, Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. Division of Epidemiology & Biostatistics, School of Public Health & Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. SA MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.

Abstract summary 

Youth living with perinatally acquired HIV (YLPHIV) have been found to have a range of mental disorders. Some adult HIV studies have linked mental health to adverse metabolic outcomes due to dysregulation of the sympathetic nervous system and hypothalamic-pituitary-adrenal axis, but this association has not previously been explored in YLPHIV.We investigated the association of mental health measures with metabolic outcomes in YLPHIV and HIV-uninfected youth (HIV-U) and linear regression was used to assess the adjusted associations.Overall, 203 YLPHIV (median age = 10.7years; 52% female; mean duration on ART 8 years, 12% CD4 count <500 cells/µL, 18% viral load >50 copies/mL) and 44 HIV-U (median age = 10.3 years; 55% female) were enrolled. YLPHIV had higher median total cholesterol (4.2 vs 3.9 mmol/L, = 0.049) and triglyceride (0.9 vs 0.7 mmol/L, < 0.001) compared to HIV-U. We found higher percentage of poor functional competence (40% vs 25%, = 0.02) and self-concept (23% vs 9%, = 0.03) and higher depression (6% vs 2%, < 0.01), anger (6% vs 2%, = 0.04) and disruptive behaviour (4% vs 0%, < 0.01) in YLPHIV as compared to HIV-U. Among YLPHIV, higher scores of anger were associated with higher total cholesterol and higher low-density lipoprotein (ß = 0.010, = 0.041 and ß = 0.012, = 0.048 respectively) and disruptive behaviour with higher low-density lipoprotein (ß = 0.010, = 0.043) after adjusting for age, sex and BMIZ.This is the one of first study to investigate the association of mental health with metabolic outcomes among YLPHIV. The association of increased anger and disruptive behaviour with increased lipid concentration is a novel finding. Further longitudinal studies are needed to evaluate the causal relationships between mental health and metabolic outcomes.

Authors & Co-authors:  Mahtab Sana S Jao Jennifer J Myer Landon L Phillips Nicole N Stein Dan J DJ Zar Heather J HJ Hoare Jacqueline J

Study Outcome 

Source Link: Visit source

Statistics
Citations :  Barlow‐Mosha L, Ross Eckard A, McComsey GA, & Musoke PM (2013). Metabolic complications and treatment of perinatally HIV‐infected children and adolescents. Journal of the International AIDS Society, 16(1), 18600.
Authors :  7
Identifiers
Doi : 10.1080/09540121.2021.1950605
SSN : 1360-0451
Study Population
Male,Female
Mesh Terms
Adolescent
Other Terms
HIV;Youth living with perinatally acquired HIV;antiretroviral therapy;mental health;metabolic outcome
Study Design
Longitudinal Study,Cross Sectional Study
Study Approach
Country of Study
Publication Country
England