When it coincides with HIV, depression appears associated with an increased risk of death, a new study says.

Researchers analysed data from the US Veteran’s Aging Cohort Study to compare the risk of death among those with and without depression, and the association between depression and death among those with and without HIV, the virus that causes Aids.

Increased risk of death

Depression was assessed in two ways: by clinical diagnostic codes and by a depressive symptoms questionnaire.

Among those with HIV infection, a 23% increased risk of death was associated with greater levels of depression as determined by the questionnaire. But there was no significantly increased risk of death when depression was assessed by the diagnostic codes.

For those without HIV, a 6% increased risk of death was associated with greater levels of depression measured by the codes. But there was no significant increased risk of death when depression was assessed by the questionnaire.

The Boston University School of Medicine study was published online in the journal HIV Medicine.

“Our findings reinforce the need to assess and treat depressive symptoms and major depressive disorder in patients with and without HIV infection to potentially reduce [death] risk,” corresponding author Kaku So-Armah said in a school news release. So-Armah is an assistant professor of medicine.

No cause-and-effect relationship

Clinical guidelines recommend routine screening for depression, but adherence to those guidelines varies, resulting in under-diagnosis of depression among HIV patients, according to the researchers.

“This needs to be improved,” the authors wrote. They called for more effective depression screening and integration of depression treatment into HIV primary care.

Depression is the most commonly reported mental health disorder among Americans with HIV, affecting 20% to 40%.

Depression has been linked with an increased risk of death in people with chronic diseases such as heart disease, end-stage kidney disease and diabetes.

This new study cannot prove a cause-and-effect relationship. Several previous studies have found an association between depression and an increased risk of death among people with HIV, but there is conflicting data.

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