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Effects of cognitive behavioral stress management on HIV-1 RNA, CD4 cell counts and psychosocial parameters of HIV-infected persons.
AIDS 2008; 22(6):767-75AIDS

Abstract

OBJECTIVE

To determine the effects of cognitive-behavioral stress management (CBSM) training on clinical and psychosocial markers in HIV-infected persons.

METHODS

A randomized controlled trial in four HIV outpatient clinics of 104 HIV-infected persons taking combination antiretroviral therapy (cART), measuring HIV-1 surrogate markers, adherence to therapy and well-being 12 months after 12 group sessions of 2 h CBSM training.

RESULTS

Intent-to-treat analyses showed no effects on HIV-1 surrogate markers in the CBSM group compared with the control group: HIV-1 RNA < 50 copies/ml in 81.1% [95% confidence interval (CI), 68.0-90.6] and 74.5% (95% CI, 60.4-85.7), respectively (P = 0.34), and mean CD4 cell change from baseline of 53.0 cells/microl (95% CI, 4.1-101.8) and 15.5 cells/microl (95% CI, -34.3 to 65.4), respectively (P = 0.29). Self-reported adherence to therapy did not differ between groups at baseline (P = 0.53) or at 12 month's post-intervention (P = 0.47). Significant benefits of CBSM over no intervention were observed in mean change of quality of life scores: physical health 2.9 (95% CI, 0.7-5.1) and -0.2 (95% CI, -2.1 to 1.8), respectively (P = 0.05); mental health 4.8 (95% CI, 1.8-7.3) and -0.5 (95% CI, -3.3 to 2.2) (P = 0.02); anxiety -2.1 (95% CI, -3.6 to -1.0) and 0.3 (95% CI, -0.7 to 1.4), respectively (P = 0.002); and depression -2.1 (95% CI, -3.2 to -0.9) and 0.02 (95% CI, -1.0 to 1.1), respectively (P = 0.001). Alleviation of depression and anxiety symptoms were most pronounced among participants with high psychological distress at baseline.

CONCLUSION

CBSM training of HIV-infected persons taking on cART does not improve clinical outcome but has lasting effects on quality of life and psychological well-being.

Authors+Show Affiliations

Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Zurich, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18356607

Citation

Berger, Simona, et al. "Effects of Cognitive Behavioral Stress Management On HIV-1 RNA, CD4 Cell Counts and Psychosocial Parameters of HIV-infected Persons." AIDS (London, England), vol. 22, no. 6, 2008, pp. 767-75.
Berger S, Schad T, von Wyl V, et al. Effects of cognitive behavioral stress management on HIV-1 RNA, CD4 cell counts and psychosocial parameters of HIV-infected persons. AIDS. 2008;22(6):767-75.
Berger, S., Schad, T., von Wyl, V., Ehlert, U., Zellweger, C., Furrer, H., ... Gaab, J. (2008). Effects of cognitive behavioral stress management on HIV-1 RNA, CD4 cell counts and psychosocial parameters of HIV-infected persons. AIDS (London, England), 22(6), pp. 767-75. doi:10.1097/QAD.0b013e3282f511dc.
Berger S, et al. Effects of Cognitive Behavioral Stress Management On HIV-1 RNA, CD4 Cell Counts and Psychosocial Parameters of HIV-infected Persons. AIDS. 2008 Mar 30;22(6):767-75. PubMed PMID: 18356607.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of cognitive behavioral stress management on HIV-1 RNA, CD4 cell counts and psychosocial parameters of HIV-infected persons. AU - Berger,Simona, AU - Schad,Tanja, AU - von Wyl,Viktor, AU - Ehlert,Ulrike, AU - Zellweger,Claudine, AU - Furrer,Hansjakob, AU - Regli,Daniel, AU - Vernazza,Pietro, AU - Ledergerber,Bruno, AU - Battegay,Manuel, AU - Weber,Rainer, AU - Gaab,Jens, PY - 2008/3/22/pubmed PY - 2008/6/12/medline PY - 2008/3/22/entrez SP - 767 EP - 75 JF - AIDS (London, England) JO - AIDS VL - 22 IS - 6 N2 - OBJECTIVE: To determine the effects of cognitive-behavioral stress management (CBSM) training on clinical and psychosocial markers in HIV-infected persons. METHODS: A randomized controlled trial in four HIV outpatient clinics of 104 HIV-infected persons taking combination antiretroviral therapy (cART), measuring HIV-1 surrogate markers, adherence to therapy and well-being 12 months after 12 group sessions of 2 h CBSM training. RESULTS: Intent-to-treat analyses showed no effects on HIV-1 surrogate markers in the CBSM group compared with the control group: HIV-1 RNA < 50 copies/ml in 81.1% [95% confidence interval (CI), 68.0-90.6] and 74.5% (95% CI, 60.4-85.7), respectively (P = 0.34), and mean CD4 cell change from baseline of 53.0 cells/microl (95% CI, 4.1-101.8) and 15.5 cells/microl (95% CI, -34.3 to 65.4), respectively (P = 0.29). Self-reported adherence to therapy did not differ between groups at baseline (P = 0.53) or at 12 month's post-intervention (P = 0.47). Significant benefits of CBSM over no intervention were observed in mean change of quality of life scores: physical health 2.9 (95% CI, 0.7-5.1) and -0.2 (95% CI, -2.1 to 1.8), respectively (P = 0.05); mental health 4.8 (95% CI, 1.8-7.3) and -0.5 (95% CI, -3.3 to 2.2) (P = 0.02); anxiety -2.1 (95% CI, -3.6 to -1.0) and 0.3 (95% CI, -0.7 to 1.4), respectively (P = 0.002); and depression -2.1 (95% CI, -3.2 to -0.9) and 0.02 (95% CI, -1.0 to 1.1), respectively (P = 0.001). Alleviation of depression and anxiety symptoms were most pronounced among participants with high psychological distress at baseline. CONCLUSION: CBSM training of HIV-infected persons taking on cART does not improve clinical outcome but has lasting effects on quality of life and psychological well-being. SN - 1473-5571 UR - https://www.unboundmedicine.com/medline/citation/18356607/Effects_of_cognitive_behavioral_stress_management_on_HIV_1_RNA_CD4_cell_counts_and_psychosocial_parameters_of_HIV_infected_persons_ L2 - http://Insights.ovid.com/pubmed?pmid=18356607 DB - PRIME DP - Unbound Medicine ER -