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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?

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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