Physical and psychological symptoms can predict increases in viral load in patients taking antiretroviral therapy who have an undetectable viral load, researchers from London report in the August 15thedition of the Journal of Acquired Immune Deficiency Syndromes.
Individual symptoms especially associated with a rebound in viral load included worry, feeling sad and diarrhea.
“The most likely mechanism linking symptoms to virologic rebound is cART [combination antiretroviral therapy] nonadherence, including treatment interruption or discontinuation”, comment the investigator. They add,“it is possible that symptom measures capture additional information about nonadherence that is not captured by direct inquiry on missed cART doses.”
Earlier research has shown that depression may predict disease progression in patients with HIV, but researchers at the Royal Free Hospital in London wanted to see is physical and psychological symptoms could predict increases in viral load in patients taking antiretroviral therapy.
They note that this is the first study to show an association between physical symptoms and increases in viral load. They suggest that “physical symptoms may result in anxiety and depression, or be manifestations of psychological distress.”
The researchers believe that their findings could have implications for the type of care offered patients taking treatment. They suggest that an assessment “of virologic failure risk that is based solely on laboratory results, treatment history and adherence may be missing an important dimension – information from the patient’s perspective”.
A simple assessment of symptoms would identify patients at risk of treatment failure, they suggest, and “provide an opportunity not only for addressing adherence but also for appropriate medical or psychological interventions to address physical symptoms and psychological distress.”