alexa A comparison of the clinical features of depression in hiv-positive and hiv-negative patients in Uganda

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A comparison of the clinical features of depression in hiv-positive and hiv-negative patients in Uganda

HIV/AIDS is a global health problem. In the last 2 decades it has claimed nearly 30 million lives. About 40 million people are now living with HIV/AIDS and Sub-Saharan Africa remains by far the worst affected region in the world with a continental prevalence of around 7.4%2; two thirds (64%) of all people living with HIV/AIDS are in sub-Saharan Africa. A significant number of HIV infected people develop mental health problems, which not only impinge on their knowledge that they are likely to die prematurely of AIDS and the direct and indirect effects of HIV on the brain. Depressive symptoms in HIV/AIDS have been associated with disease progression suggesting that it may be a manifestation of the HIV disease process itself or advanced immunosupression. Suicide is frequently observed among HIV patients with its prevalence to ranging from 7 to 36 times the rate in demographically similar control populations. Furthermore, untreated depression in HIV/AIDS often leads to poor or noncompliance with any treatment given, including ARVs, which can lead to development of resistant strains of the HIV virus.


This study showed that HIV-related depression is clinically different from the depression found in HIV-negative patients. It appears to be acquired and therefore a secondary depressive illness as opposed to the genetically driven primary affective depressive disorder of HIV-negative patients. This requires further study. The HIV-related depression was characterized by negative family history of mental illness, use of medication for treating an illness other than depression, older age of the patients, older age of onset of the depression and cognitive impairment. Compared to HIV-negative patients, HIV-positive patients were more critical of themselves, had problems with decision making, had more sleep and more appetite disturbances. They also felt more fatigued with significant cognitive impairment. These findings call for routine screening for depressive illnesses in all HIV infected individuals especially in late onset depressive illness and in populations highly endemic for HIV/AIDS as well as for effective treatment of the depression of HIV/AIDS and its associations.

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