CD4+ T Cell Count, Sleep, Depression, and Anxiety in People Living With HIV: A Growth Curve Mixture Modeling.
Yirong Shi, Chongming Yang, Liumei Xu and 8 others
PMID 31335460WHAT IT FOUND
In Chinese adults with HIV, CD4+ T cell counts rose in most participants.
Sleep, anxiety, and depression did not improve. In a small group whose counts fell, sleep worsened and depression and anxiety rose.
Key findings
01For most participants, CD4+ T cell counts increased over time, but sleep quality, anxiety, and depression did not improve.
02In a smaller subgroup, CD4+ T cell counts decreased, depression and anxiety increased, and sleep quality deteriorated.
03Being married and using alcohol were associated with a higher likelihood of belonging to the subgroup with decreasing CD4+ T cell counts.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done in one outpatient clinic in Shenzhen, China, and most participants were men, so the results may not apply to other HIV populations. It was an observational study, so it cannot show that CD4+ T cell changes caused changes in sleep, anxiety, or depression. The deteriorating pattern was seen in only 27 participants. The paper reports 247 selected participants and 220 completing the final assessment, while the two described classes are 220 and 27, so the exact analysis sample is unclear. CD4+ T cell counts were grouped into three categories rather than analyzed as continuous counts. People with AIDS-related cognitive impairment or complications were excluded, so the findings do not apply to that group. The study did not examine biomolecular mechanisms or future adverse events and optimism, which could confound the relationships.
Declared interests
The authors report no real or perceived vested interests related to this article.
The easy way to misread this
Do not conclude that CD4+ T cell decline causes worse sleep, anxiety, or depression. The study did not test causal mechanism, and the pattern appeared only in a small subgroup.