Psychological distress and physical pain appear to have no short-term adverse impact on plasma HIV-1 RNA levels in patients on successful HAART

Purpose: Previous studies have linked depression and stressful life events in HIV disease with a more rapid decline in CD4 count and progression to AIDS. However, the short-term effect of psychological and physical distress on HIV-1 RNA levels in patients on successful HAART has not been well studied. Method: Ten asymptomatic HIV-infected adults with suppression of viremia to <50 copies/mL on a stable HAART regimen for ≥6 months were studied. Participants donated blood every 2-3 days over a 3-4 month period for duplicate independent viral load measurements and drug level monitoring. At each time point, psychological distress was measured using the Mental Health Inventory-5 (MHI-5) and an 11-point numeric rating scale for emotional stress. Physical pain was assessed using an 11-point numeric rating scale. Results: All patients maintained successful viral suppression throughout the study. Twenty-six of 713 (3.6%) viral load measurements were >50 copies/mL. Psychological distress and physical pain were not associated with episodes of detectable viremia. Conclusion: Using frequent monitoring of HIV-1 RNA levels and patient ratings of mood, stress, and pain, we found that psychological distress and physical pain had no short-term adverse impact on HIV-1 RNA levels in highly adherent patients with stable suppression of viremia on HAART.