Psychiatric symptoms are highly prevalent in people living with HIV (PLHIV). For example, in PLHIV the prevalence rates of depression and alcohol use disorder are both approximately two times higher as compared to the general population. The high occurrence of psychiatric symptoms in PLHIV is of major importance, since it is one of the main factors determining quality of life. In addition, psychiatric symptoms in PLHIV may cause suboptimal combination antiretroviral therapy adherence and increase transmission risk behaviour, and the frequent use of various substances in PLHIV could affect immune function.
Several mechanisms may be involved in the increased prevalence of psychiatric symptoms in PLHIV. Besides psychological mechanisms (such as social stress due to HIV-related stigma), also biological mechanisms are likely to play a role. For example, HIV infection has been shown to decrease dopamine sensitivity, which has been associated with vulnerability for addiction. Moreover, chronic HIV infection is known to involve persistent inflammation, and pro-inflammatory cytokines have been associated with the development of depression.
The 2000HIV study aims to obtain a deeper insight in biological mechanisms involved in psychiatric symptoms in PLHIV. We focus on symptoms of depression, anxiety, impulsivity and substance use, which we measure using the following self-questionnaires: the Hospital Anxiety and Depression Scale (HADS), the Barratt Impulsiveness Scale (BIS-11), and the Measurements in the Addictions for Triage and Evaluation Q (MATE-Q).
Where previous studies commonly explored a single set of psychiatric symptoms in relation to a single set of biomarkers, the 2000HIV study will use an transdiagnostic, multi-omics approach. This will allow an unbiased assessment of numerous biological pathways on a highly detailed level, and can potentially result in the discovery of new mechanisms involved in depression, anxiety, impulsivity and substance use in PLHIV.