Single Site Prevalence of Depression among HIV Patients on ART, MCC Honors



Julia Y. Cheung

Cheung, Julia Y.1, Schaubel, Douglas E.2
Faculty / Advisor: Omolehina, Temitope T.3
1University of Pennsylvania School of Dental Medicine, Department of Preventive and Restorative Sciences
2University of Pennsylvania School of Dental Medicine, Biostatistics
3University of Pennsylvania School of Dental Medicine, Department of Oral Medicine

Introduction

A pilot study assessing the prevalence of psychiatric and neurocognitive disorders (PNDs) among HIV patients at a single site dental school clinic. We evaluated associations between diagnosis of psychiatric conditions, ART used, and patients’ social history. The hypothesis is that there is a high prevalence of PNDs among patients living with HIV (PLWH), with risk factors including drug and alcohol abuse as well as type of antiretroviral therapy (ART) used.

Methods

Medical records of n=204 randomly selected PLWH on ART at the University of Pennsylvania School of Dental Medicine were reviewed. Data on presence/absence of PNDs obtained through self-report and physician diagnosis, ART medication and social history were acquired from dental and medical records. Each PND was coded as 0 (condition absent) or 1 (condition present); we modeled these outcomes using logistic regression, adjusting for all factors listed in Table 1.

Results

Of the n=204 subjects, a total of 25 (~12% of sample) had anxiety, while 68 had depression (33% of sample). As shown in Table 1, the association between age and each of anxiety (p=0.081) and depression (p=0.091) is near-significant. A five-year increase in age is associate with a 17% decrease in anxiety risk. Alcohol had a near-significant association (p=0.078) with anxiety. Patients who reported alcohol use had 132% increase in anxiety. Depression was more prevalent in patients on Triumeq (Albacavir, Dolutegravir and lamivudine), while Descovy (Emtrictabine and tenofoviralafenamide was least associated with depression (odds ratio 3.72 and 0.17 respectively).

Conclusion

Depression was the most prevalent condition among PLWH at Penn Dental Medicine, while alcohol use was significantly associated with anxiety. Since PNDs are prevalent among PLWH, routine assessments in dental clinics will help with early detection, as well as possibly prevent the effects of these conditions on oral health outcomes. Future studies will include understanding the impact of depression, anxiety and neurocognitive disorders on oral health outcomes among PLWH. Limitations of study were typical of retrospective studies.