Mood disorders in HIV infection

Introduction Psychiatric disorders, particularly mood disorders, have a profound effect on the use of and adherence to highly active antiretroviral therapy (HAART) among patients with human immunodeficiency virus (HIV) infection. HIV infection and mood disorders have features in common, and each is a significant risk factor for the other. Objective The objective is to highlight the clinicians on the importance of screening and treating affective disorders among patients with HIV infection. Methods Two cases of HIV infected patients with comorbid mood disorder and torpid evolutions by poor adherence to treatment are reported. A brief literature review on this subject is done. Results Major depression has been shown to alter the function of killer lymphocytes in HIV-infected patients and may be associated with the progression of HIV disease. HIV-positive patients with mental disorders are less likely to receive and adherence to antiretroviral therapy. First case-report: a man 52 years old, HIV-positive since 1985 with a comorbid bipolar disorder, with recurrent depressions and poor adherence to both treatment with a rapidly exitus laetalis. Second case-report: man 45 years old, HIV-positive since 1992 with a comorbid depressive disorder, non-adhered to both therapy and HIV-associated dementia. Conclusions Depressive disorders are common in HIV infection. Antiretroviral regimens for HIV-infected patients require strict adherence. Untreated depression has been associated with medication nonadherence. Understanding the contribution of depression and its subsequent treatment on antiretroviral therapy adherence might direct clinicians toward earlier identification and more aggressive treatment among this population.