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Disclosures: The authors report no relevant financial disclosures.
July 05, 2020
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In women with HIV, depression, stress may worsen carotid atherosclerosis

Source/Disclosures
Disclosures: The authors report no relevant financial disclosures.
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Among women living with HIV, those at high psychosocial risk had higher carotid plaque prevalence and were more likely to have formed new plaque compared with those at low psychosocial risk, researchers reported.

However, the researchers found no relationship between carotid plaque and psychosocial risk status in women without HIV.

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The researchers analyzed 700 women from the Women’s Interagency HIV Study, which includes women living with HIV and women of similar demographics who are at risk for HIV but do not have it. All participants had ultrasound to measure carotid artery focal plaque in 2004-2005 and 2010-2012.

The cohort (median age, 47 years) was divided into those at high psychosocial risk (n = 163; 65% with depression; 96% with high stress; 46% with probable PTSD) and those at low psychosocial risk (n = 537; 13% with depression; 12% with high stress; 2% with probable PTSD).

In women living with HIV, plaque prevalence was 23% in the high psychosocial risk group compared with 11% in the low psychosocial risk group (adjusted OR = 2.12; 95% CI, 1.11-4.05), Matthew E. Levy, PhD, postdoctoral research scientist in the department of epidemiology, Milken Institute School of Public Health, George Washington University, and colleagues wrote.

However, in women without HIV, there was no difference between the groups in plaque prevalence (9% for both; aOR = 1.07; 95% CI, 0.24-4.84).

In addition, among women living with HIV, 17% of those who reported high depressive symptoms in at least 45% of visits had new plaque formation between the imaging studies compared with 9% of those who did not (aOR = 1.96; 95% CI, 1.06-3.64), whereas the same was not true for women without HIV (9% vs. 7%, respectively; aOR = 0.82; 95% CI, 0.16-4.16), researchers reported.

“Our findings build on prior research conducted among women living with HIV in the Women’s Interagency HIV Study that found a positive association between persistently high depressive symptoms and higher Framingham coronary risk scores, which utilized measures for CVD risk factors (but not subclinical CVD),” the researchers wrote. “Research is needed to determine whether interventions for depression and psychosocial stress can mitigate the increased risk of atherosclerosis for women living with HIV.”