HIV Treatment with Antiretroviral Therapy Mitigates the High Risk of Mental Health Disorders Associated with HIV Infection in US Population
Abstract
Introduction Whether treatment of HIV with ART is associated with lower risk of MHD among people living with HIV (PLWH) remains unknown. We aim to determine the association between HIV and MHD and whether ART alters the risk of MHD among PLWH in the US adult population.
Methods We conducted a real-world study using the MerativeTM MarketScan® claims database (2016-2020), identifying individuals with HIV diagnosed using the ICD-10 codes and those without HIV. A multivariable stratified Cox proportional hazards regression model was conducted to examine the association of HIV treatment status with MHD, adjusting for potential confounders. Additionally, we sought to determine the effect of modification of ART.
Results A total, of 313,539 individuals, mean age ([SD] of 44.2 [11.4] years), predominantly males (81.2%), residing in the South region of the US (50.9%) were included in the present analysis. During 671,880 person-years of follow-up, 46,235 incident MHD cases occurred. In the multivariable Cox proportional hazard model, PLWH was associated with higher risk of incident MHD. Relative to those without HIV, the adjusted HR was 1.85 (95% CI, 1.79–1.92; P < 0.001) for those with HIV on treatment, and 2.70 (95% CI, 2.59–2.82; P < 0.001) for those with HIV without any treatment. Stronger associations between HIV and MHD were observed in men relative to women, among those aged 18-34 relative to those aged 55-63, and those with no overweight/obesity relative to obese individuals (P-interaction <0.001 for all).
Conclusions HIV was associated with an increased risk of developing MHD. However, HIV treatment mitigated the risk.
