The burden of neuropsychiatric disorders in patients living with HIV-1 treated with antiretroviral therapies—A perspective from US Medicaid data
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Background People with human immunodeficiency virus (HIV)-1 face challenges with treatment adherence for various reasons, including consideration of neuropsychiatric disorders and neuropsychiatric adverse reactions associated with antiretroviral therapy (ART). Methods A retrospective cohort study was conducted using administrative claims data from the IBM MarketScan ® Multi-State Medicaid Database (1/1/2014–12/31/2017). Adults (≥18 years) diagnosed with HIV-1 and newly initiated on antiretroviral therapy with continuous health plan enrollment were included. Primary outcome was the 6-month period prevalence of neuropsychiatric events (NPEs) of interest after ART initiation. Results Among 1971 newly treated patients included in the study, mean age (standard deviation [SD]) was 38.5 (12.7) years, and 41.4% were female. During the 6 months after ART initiation, 51.4% of patients had a claim for ≥1 NPE versus 30.3% of matched patients without HIV. Among newly treated patients, the most common (≥10%) NPE claims were for depression (42.2%), anxiety (15.8%), headache (11.9%), and bipolar/manic depression (10.1%). Also in this group, the mean (SD) total all-cause healthcare cost during the 6-month post-ART initiation was $16,632 ($33,928), of which $2914 ($18,233) was NPE-related. Conclusions In summary, in this Medicaid study of people newly initiated on ART, there was a high prevalence of NPEs, and incremental NPE-associated costs were considerable.Keywords:
Depression
Van Praet, Jens T. MD, PhD; Serrien, Ben PhD; Ausselet, Nathalie MD; Darcis, Gilles MD, PhD; Demeester, Rémy MD; De Munter, Paul MD, PhD; De Scheerder, Marie-Angélique MD, PhD; Goffard, Jean-Christophe MD; Libois, Agnès MD; Messiaen, Peter MD, PhD; Yombi, Jean Cyr MD; Van Beckhoven, Dominique MD; on behalf of the Belgian HIV Cohort Study Group Author Information
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Background: Atrial Fibrillation (AF) ablations are performed in pts of all age groups. No data exists on the outcomes or Quality of Life (QOL) specific to the octogenarian population undergoing this procedure. We hypothesize the outcomes and risks would not be too dissimilar when compared to a younger cohort between 65-79 years. Methods: From a retrospective database we selected octogenarian pts compared to an age and sex matched control group, ages 65-79. Pre-ablation tests were performed as well as quality of life (QoL) and symptom inventories. Results of the ablation procedure, follow up QoL and symptom inventories, peri-procedure morbidity and freedom from AF or control of AF with anti-arrhythmic agents were compared between the 2 groups. Results: During follow-up (mean 2.3 ± 2.2 years), AF elimination (70% vs 81%, p 0.942) and AF control including those on antiarrhythmic agents (86% vs 86%, p 0.249) were compared. Conclusion: Outcomes of ablation in the octogenarians are highly favorable with no increase in procedural complications. Improvement in QOL scores is impressive in patients with advancing age. Comparison of variables between the Young-Old and the Octagenerian cohort of patients undergoing ablation of drug-refractory AF Comparison of variables between the Young-Old and the Octagenerian cohort of patients undergoing ablation of drug-refractory AF
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Objective To investigate the incidence of cardiovascular patients with anxiety depression symptoms and to explore the effects of antianxiety and anti-depression intervention on these symptoms.Methods The 377 cardiovascular patients with anxiety depression symptoms,who were accepted the drug treatment to angiocardiopathy actively and appropriately,were administrated with drug of antianxiety and anti-depression.Results Approximately 40.05% of cardiovascular patients were complicated with anxiety depression symptoms,including 21.22% with anxiety,6.37% with depression and 12.46 % with anxiety and depression.About 92.72% of these patients had good response to the drugs of antianxiety and anti-depression.Conclusion Anxiety depression is common in cardiovascular patients.Administrating drug of antianxiety and anti-depression would have good effects in cardiovascular patients with anxiety depression symptoms.
Depression
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A 33year-old man was admitted to the medical ward at Queen Elizabeth Central Hospital for evaluation of a pleural effusion that had progressed despite anti-bacterial and tuberculosis treatment. Eight months earlier he was diagnosed with sputum smear alcohol and acid-fast bacilli [AAFB] negative pulmonary tuberculosis. At that time his symptoms were fever, night sweats, cough and shortness of breath. The results of his initial chest X-ray are not known. He received standard tuberculosis treatment (rifampicin, isoniazid, pyrazinamide and ethambutol for 2 months followed by rifampicin and isoniazid for four months). He stated that his symptoms improved during the first two months of tuberculosis treatment,but he then developed a pleural effusion that was tapped three times over the course of the four months prior to admission. Straw colored fluid was obtained twice but results of microbiological and biochemical analysis of the pleural fluid samples were not available.The last time a dry pleural tap was recorded. Courses of amoxicillin and chloramphenicol were given without improvement. Five days before admission he developed progressive complaints of productive cough with brownish sputum and shortness of breath on exertion. He had no constitutional symptoms. He was a lifetime non-smoker and had no exposure to asbestos or significant amounts of particulate matter. He was HIV positive with World Health Organization (WHO)
Pyrazinamide
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Objective To investigate the incidence of type 2 diabetic inpatients' anxiety and depression,and discuss the treatment effect of health education.Methods We investigated the anxiety and depression of type 2 diabetic inpatients between January 2009 and May 2012,gave health education to the anxious and depressed patients,and reevaluation was carried out when the patients were discharged from the hospital.Results The result showed that 22.45% of the type 2 diabetic inpatients had anxiety,and 11.37% of them had depression.After the health education,the number of anxious patients was markedly reduced(P 0.05),especially in patients with mild and moderate anxiety,but it had no distinct improvement in severely anxious patients.To all the depressed patients,health education had bad curative effect,especially in those with moderate and serious depression.Conclusion Anxiety and depression have high incidence in type 2 diabetic inpatients,and health education is an effective treatment for patients with mild and moderate anxiety.
Depression
Anxiety score
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Objective: To investigate the depression and anxiety in patients with asthma. Methods: With SAS and SDS,100 asthmatic patients were assessed. Results: The mean scores of SAS and SDS were 54.12±6.47, 44.8±7.28 respectively. 68% of sample had anxiety and 78% had depression. Conclusion: Most of patients with asthma have anxiety and depression. It suggests the treament of depression and anxiety for asthmatic patients are needed besides the conventional treatment.
Depression
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