HIV is a serious viral infection that claims the lives of many people today. When observing and thinking about this disease, most people know what causes it: unprotected sex or using used needles. However, there are certain things that could make this disease worse. It has been found that depression is something that can make the effects of HIV worse. The connection between depression and HIV progression involves the interaction of various biological, behavioral, and environmental variables. Untreated depression leads to behavioral and psychological risk factors resulting in faster disease progression which is measured by immunological markers.
Major depressions results in overactivation of the HPA axis. This results in excessive secretion and inhibited regulation of glucocorticoids. Glucocorticoids are anti-inflammatory compounds that are involved in carbohydrate, fat, and protein metabolism, and many other bodily activites.The elevated levels of these hormones compromises some of the mechanisms of the immune response system against antigens. Some of these compromises include induced cell death and removal of T cells from the circulation as the lymphocyte production in the thymus is interrupted. Studies have also shown that glucocorticoids enhance HIV replication. Depression also leads to blunted production and activity of coxycotic lymphocytes (NK cells) and an elevation of inflammatory cytokines which disturbs immune response. Elevated cortisol is also likely to play a primary role in the link between depression and HIV progression. What leads to elevated cortisol levels?
There is also found to be an association between HIV, depression, and substance abuse. The HIV Cost and Services Utilization Study, which is a large national study of HIV infected individuals receiving medical care, documented elevated rates for substance abuse . Among the HIV-positive individuals suffering from substance abuse, depression was well documented. The studies showed that HIV positive individuals who suffered from substance abuse were more likely to report elevated levels of depression than HIV positive individuals who were substance users. One of the problems associated with HIV- positive individulas sufferieng from substance abuse is elevated cortisol levels caused by drugs/alcohol. This is linked with immunosupression.
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