Severe Stress, Depressive Symptoms, and Changes in Lymphocyte Subsets in Human Immunodeficiency Virus--Infected Men: A 2-Year Follow-up Study

doi:10.1001/archpsyc.1997.01830150105015

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Vol. 54 No. 3, March 1997

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Severe Stress, Depressive Symptoms, and Changes in Lymphocyte Subsets in Human Immunodeficiency Virus—Infected Men

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 symptomswere related to changes in immune measures during a 2-year periodin a sample of gay men with human immunodeficiency virus (HIV)infection. These analyses follow up our initial crosssectionalobservations that severe stress was correlated with lower levelsof natural killer (NK) cells and CD8⁺ T lymphocytes in thesemen.

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 relatedto decreases on immune measures from entry to 2-year follow-up,that is, declines in CD8⁺ T cells and CD56⁺ and CD16⁺ NK cellsubsets. Subjects most likely to have decreases on these immunemeasures were those who scored above the median on both stressand depressive symptoms.

Conclusions
Our findings are among the first prospective data showing thatstress and depressive symptoms, especially when they occur jointly,are associated with decreased number of NK and CD8⁺ T lymphocytesin HIV-infected men. Since these immune cells may play a protectiverole in the progression of HIV infection, our data suggest thatstress and depressive symptoms may have clinical implicationsfor 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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