PTSD co-morbid with HIV: Separate but equal, or two parts of a whole?

• Type of Material: Article
• Authors: Gretchen Neigh, Emory University; Siara T. Rhodes, Georgia State University; Arielle Valdez, Emory University; Tanja Jovanovic, Emory University
• Language: English
• Date: 2016-08-01
• Publisher: Elsevier
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 The Authors.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.nbd.2015.11.012
• Title of Journal or Parent Work: Neurobiology of Disease
• ISSN: 0969-9961
• Volume: 92
• Issue: Pt B
• Start Page: 116
• End Page: 123
• Grant/Funding Information: This work was supported by the Creative and Novel Ideas in HIV Research Program (CNIHR) through a supplement to the University of Alabama at Birmingham (UAB) Center for AIDS Research funding (P30 AI027767-24).
• Keywords: GLUCOCORTICOID-RECEPTOR; Science & Technology; Stress; Hormones; QUALITY-OF-LIFE; POSTTRAUMATIC-STRESS-DISORDER; PTSD; Neurosciences & Neurology; HIV; Life Sciences & Biomedicine; FEAR-POTENTIATED STARTLE; TRANSGENIC RATS EVIDENCE; ANXIETY DISORDERS; HUMAN-IMMUNODEFICIENCY-VIRUS; PITUITARY-ADRENAL AXIS; Neurosciences; INFECTED INDIVIDUALS; Startle; PRIMARY-CARE PATIENTS
• Research Categories: Psychology, Behavioral; Biology, Virology

Abstract

Approximately 30 million people currently live with HIV worldwide and the incidence of stress-related disorders, such as post-traumatic stress disorder (PTSD), is elevated among people living with HIV as compared to those living without the virus. PTSD is a severely debilitating, stress-related psychiatric illness associated with trauma exposure. Patients with PTSD experience intrusive and fearful memories as well as flashbacks and nightmares of the traumatic event(s) for much of their lives, may avoid other people, and may be constantly on guard for new negative experiences. This review will delineate the information available to date regarding the comorbidity of PTSD and HIV and discuss the biological mechanisms which may contribute to the co-existence, and potential interaction of, these two disorders. Both HIV and PTSD are linked to altered neurobiology within areas of the brain involved in the startle response and altered function of the hypothalamic-pituitary-adrenal axis. Collectively, the data highlighted suggest that PTSD and HIV are more likely to actively interact than to simply co-exist within the same individual. Multi-faceted interactions between PTSD and HIV have the potential to alter response to treatment for either independent disorder. Therefore, it is of great importance to advance the understanding of the neurobiological substrates that are altered in comorbid PTSD and HIV such that the most efficacious treatments can be administered to improve both mental and physical health and reduce the spread of HIV.