Asociación entre la severidad de la depresión y el apego al primer esquema de tratamiento antirretroviral

Abstract

OBJECTIVE: To compare the rate of adherence to antiretroviral therapy in the first line in patients with depressive disorders vs those without depression. MATERIAL AND METHOD: A prospective study was done from January to June 2016 in patients from the HIV clinics of the Regional General Hospital No. 1 of IMSS, and the General Hospital Tacuba, in antiretroviral treatment with a first scheme, started more than six months ago, excluding patients with neurological disorders, different from depression, patients with diagnosis and/or previous treatment of depression. Patients answered the Beck questionnaire for depression and the SMAQ scale for adherence. RESULTS: 180 patients were evaluated with a first antiretroviral treatment regimen. It was found that 126 (70%) patients did not present depression, 36 (20%) presented depression, 15 (8.3%) presented moderate depression and 3 (1.7%) presented severe depression. Non-adherence was observed in 15.8% of patients without depression versus 55.5% of patients with depression (p = 0.01). The adherence of patients with depression was inversely proportional to the severity of the same. Regarding the viral load under the limit of suppression (< 40 copies/mL) in patients without depression, a higher proportion of patients with a viral load higher than 40 copies/mL was observed: 17.4% vs 15.8%, considered non-adherent by the SMAQ questionnaire. CONCLUSIONS: Adherence decreases with the severity of depression in patients, putting the effectiveness of antiretroviral treatment at risk.