SEVERE STRESS, DEPRESSIVE SYMPTOMS, AND CHANGES IN LYMPHOCYTE SUBSETSIN HUMAN IMMUNODEFICIENCY VIRUS-INFECTED MEN - A 2-YEAR FOLLOW-UP-STUDY

Background: This study examined how severe stress and depressive sympt oms were related to changes in immune measures during a 2-year period in a sample of gay men with human immunodeficiency virus (HIV) infecti on. These analyses follow up our initial cross-sectional observations that severe stress was correlated with lower levels of natural killer (NK) cells and CD8(+) T lymphocytes in these men. Methods: Data were c ollected in North Carolina as part of an ongoing, longitudinal study, the Coping in Health and Illness Project. Sixty-six HIV-infected gay m en, who were asymptomatic at baseline, were assessed systematically at 6-month intervals. Results: Severe stress and depressive symptoms wer e independently related to decreases on immune measures from entry to 2-year follow-up, that is, declines in CD8(+) T cells and CD56(+) and CD16(+) NK cell subsets. Subjects most likely to have decreases on the se immune measures were those who scored above the median on both stre ss and depressive symptoms. Conclusions: Our findings are among the fi rst prospective data showing that stress and depressive symptoms, espe cially when they occur jointly, are associated with decreased number o f NK and CD8(+) T lymphocytes in HIV-infected men. Since these immune cells may play a protective role in the progression of HIV infection, our data suggest that stress and depressive symptoms may have clinical implications for the course of this disease.