Relationship of psychosocial factors to HIV disease progression1,2,3

Based on the existing empirical evidence that psychosocial variables may predict the course of human immunodeficiency virus (HIV) illness, disease progression (described by advance in symptoms, decline in CD4+ cell count, and mortality) in 414 HIV-positive (HIV+) males was studied using Cox Proportional Hazards Models (survival analysis). Depressive symptoms predicted shorter longevity after controlling for symptoms and CD4+ cell count. Large social network sizes predicted longevity among those with acquired immune deficiency syndrome (AIDS)-defining symptoms at baseline, but not among other subjects. Therefore, psychosocial variables and affective states may be related to disease outcome only during later stages of HIV disease. Although the results provide support for psychoneuroimmunologic effects in HIV, other confounding explanations may still apply.