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A 2-Year Follow-up Study

Jane Leserman, PhD; John M. Petitto, MD; Diana O. Perkins, MD; James D. Folds, PhD; Robert N. Golden, MD; Dwight L. Evans, MD

Arch Gen Psychiatry. 1997;54(3):279-285.

Abstract
Background
This study examined how severe stress and depressive symptoms were related to changes in immune measures during a 2-year period in a sample of gay men with human immunodeficiency virus (HIV) infection. These analyses follow up our initial crosssectional observations that severe stress was correlated with lower levels of natural killer (NK) cells and CD8⁺ T lymphocytes in these men.

Methods
Data were collected in North Carolina as part of an ongoing, longitudinal study, the Coping in Health and Illness Project. Sixty-six HIV-infected gay men, who were asymptomatic at baseline, were assessed systematically at 6-month intervals.

Results
Severe stress and depressive symptoms were independently related to decreases on immune measures from entry to 2-year follow-up, that is, declines in CD8⁺ T cells and CD56⁺ and CD16⁺ NK cell subsets. Subjects most likely to have decreases on these immune measures were those who scored above the median on both stress and depressive symptoms.

Conclusions
Our findings are among the first prospective data showing that stress and depressive symptoms, especially when they occur jointly, are associated with decreased number of NK and CD8⁺ T lymphocytes in HIV-infected men. Since these immune cells may play a protective role in the progression of HIV infection, our data suggest that stress and depressive symptoms may have clinical implications for the course of this disease.

Author Affiliations
From the Departments of Psychiatry (Drs Leserman, Perkins, and Golden), Medicine (Dr Leserman), and Microbiology (Dr Folds), University of North Carolina School of Medicine, Chapel Hill; and the Departments of Psychiatry (Drs Petitto and Evans), Neuroscience (Drs Petitto and Evans), Pharmacology (Dr Petitto), and Medicine (Dr Evans), University of Florida College of Medicine, Gainesville.

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