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Background <p>Mental health outcomes are substantially poorer among people with HIV than the general population. We investigated whether inflammation or HIV status may play a role in the longitudinal trajectories of depressive symptoms.</p> Methods <p>This prospective cohort study involved 862 children (291 without HIV, 292 exposed to HIV, 279 with HIV) and 439 adult caregivers (165 without HIV, 274 with HIV) recruited from 2017 to 2024 from the Kawaala Health Center IV in Kampala, Uganda. High-sensitivity C-Reactive Protein (CRP) was measured in blood serum at baseline using ELISA. Depressive symptoms were assessed longitudinally using the Patient Health Questionnaire (PHQ-9) at six-monthly intervals for up to 24 months (total 3212 observations), with 2% of children and 4% of adults meeting criteria for severe depressive symptoms (PHQ-9 score &gt; 10) at baseline. Latent growth curve modelling was used to investigate interactions between HIV status and CRP concentration on the baseline (intercept) and longitudinal change (slope) of PHQ-9 scores, separately for children and adults.</p> Results <p>Here we show that the association of baseline CRP concentrations with the intercept (β [95% confidence interval] = –0.09 [–0.18, –0.01], <i>p</i> = 0.034) and slope (<i>β</i> = 0.09 [0.03, 0.15], <i>p</i> = 0.004) of PHQ-9 score trajectories varied significantly according to HIV status among children. At higher baseline CRP concentrations, children with HIV showed lower baseline depressive symptoms relative to children without HIV. Over time, depressive symptoms increased in children with HIV but decreased in children without HIV. No differences in trajectories were observed in adults.</p> Conclusions <p>Our results suggest that given high baseline inflammation, recovery from depressive symptoms may be significantly slower among children living with HIV compared to those without HIV. Specific interventions to reduce inflammation may need to be combined with more regular, holistic and personalised interventions to alleviate depressive symptoms among children with HIV.</p>

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Longitudinal trajectories of depressive symptoms in children are associated with baseline inflammation and HIV status

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月3日

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  • Arish Mudra Rakshasa-Loots,
  • Sarah K. Zalwango,
  • Simon R. Cox,
  • Alla Sikorskii,
  • Bruno Giordani,
  • Jorem E. Awadu,
  • Amara E. Ezeamama

摘要

Background

Mental health outcomes are substantially poorer among people with HIV than the general population. We investigated whether inflammation or HIV status may play a role in the longitudinal trajectories of depressive symptoms.

Methods

This prospective cohort study involved 862 children (291 without HIV, 292 exposed to HIV, 279 with HIV) and 439 adult caregivers (165 without HIV, 274 with HIV) recruited from 2017 to 2024 from the Kawaala Health Center IV in Kampala, Uganda. High-sensitivity C-Reactive Protein (CRP) was measured in blood serum at baseline using ELISA. Depressive symptoms were assessed longitudinally using the Patient Health Questionnaire (PHQ-9) at six-monthly intervals for up to 24 months (total 3212 observations), with 2% of children and 4% of adults meeting criteria for severe depressive symptoms (PHQ-9 score > 10) at baseline. Latent growth curve modelling was used to investigate interactions between HIV status and CRP concentration on the baseline (intercept) and longitudinal change (slope) of PHQ-9 scores, separately for children and adults.

Results

Here we show that the association of baseline CRP concentrations with the intercept (β [95% confidence interval] = –0.09 [–0.18, –0.01], p = 0.034) and slope (β = 0.09 [0.03, 0.15], p = 0.004) of PHQ-9 score trajectories varied significantly according to HIV status among children. At higher baseline CRP concentrations, children with HIV showed lower baseline depressive symptoms relative to children without HIV. Over time, depressive symptoms increased in children with HIV but decreased in children without HIV. No differences in trajectories were observed in adults.

Conclusions

Our results suggest that given high baseline inflammation, recovery from depressive symptoms may be significantly slower among children living with HIV compared to those without HIV. Specific interventions to reduce inflammation may need to be combined with more regular, holistic and personalised interventions to alleviate depressive symptoms among children with HIV.