Please Note: Due to volume considerations, not all questions can be answered. Questions most likely to be answered will be those of general interest to a broad group of visitors to this forum. Questions pertaining to a specific case; requests for diagnosis, medical advice, or second opinion; or requests for opinions about untested alternative therapies will generally not be answered.
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What effect does depression have on CD4 counts?
Mar 20, 2006
I was diagnosed and began treatment in the Fall of 2004. I have been on several regimens since in an attempt to find the right combination for me. The past year I have been taking Norvir, Truvada and Reyataz. I was pleased that in September 2005 my CD4 count finally went above 100. My viral load has always remained undetectable. During the past several months I have been suffering from depression as a result of various factors. Im seeing a therapist weekly, and do feel a bit better, but I have a long way to go. My February numbers, with a recheck, my CD4 count dropped to 48. I have always remained very healthy even with the CD4 counts being under 100 for so many years. Could this drop in counts be a direct result of my depression?
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Response from Dr. Horwath
There has been much speculation about the effects of depression on physical health and the immune system, but very little good research. I know of no evidence that depression directly decreases the CD4 count.
However, there is quite a bit of evidence that HIV-infected people with depressive disorders are at risk for more HIV-related complications. The likely reason for this is that depression tends to have an adverse effect on adherence. People who are suffering from depression have a more difficult time adhering to their HIV medications.
The problem with adherence may not apply to you, but I'm including it for the benefit of others who may read this.
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