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Cited by 62Sleep and related disordersHIV/AIDS Research and InterventionsHIV Research and Treatment

Increased CD4 counts, pain and depression are correlates of lower sleep quality in treated HIV positive patients with low baseline CD4 counts

Redman, K.N., Karstaedt, A.S., Scheuermaier, K.·2018·Brain, Behavior, and Immunity
DOI 10.1016/j.bbi.2018.02.002
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Abstract

Poor sleep quality leads to increased immune activation and immune activation leads to worse sleep quality. South African HIV positive patients typically have delayed start of treatment, which has been associated with CD4+ effector T cells being more spontaneously activated in chronically treated patients. This cross-sectional study investigated whether subjective sleep quality was associated with CD4+ T lymphocyte reconstitution in treated South African HIV+ patients. One hundred and thirty-nine treated HIV+ patients (109 F, age average (SD) = 43 (9)) were recruited from Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg, South Africa. Participants completed questionnaires evaluating their subjective sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth sleepiness scale), pain, and depression severity (Beck Depression Inventory). Univariate and multivariate analyses were run to determine the correlates of sleep quality in this population. Patients had been on antiretroviral treatment for about 4 years and had increased their CD4 counts from a median at baseline of 82 to 467 cells/µL. They had overall poor sleep quality (average (SD) PSQI = 7.7 (±5), 61% reporting PSQI > 5, a marker of lower sleep quality), 41% had clinical depression (average (SD) BDI = 17 (±12)) and 55% reported pain. In two separate multivariate analyses, both the overall CD4 count increase from baseline (p = 0.0006) and higher current CD4 counts (p = 0.0007) were associated with worse sleep quality, when adjusting for depression severity (p < 0.001), daytime sleepiness (p = 0.01) and the presence of pain (p < 0.01). In this cohort of treated South African HIV positive patients, poor sleep quality was associated with higher current CD4 counts, when adjusting for depression severity, daytime sleepiness and pain. Further studies should investigate the temporal relationship between HIV-related poor sleep quality and underlying immune activation.

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  • In a South African-treated HIV-positive population, an increase in CD4 T-cell counts was associated with lower sleep quality.

    “in a recent study in a South African-treated HIV-positive population, an increase in CD4 T-cell counts was associated with lower sleep quality (461).”

    From The Sleep-Immune Crosstalk in Health and Disease (2019) · cites this paper as [461]

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Authors
Redman, K. N., Karstaedt, A. S., & Scheuermaier, K.
Affiliations
University of the Witwatersrand (ZA)
Corresponding author
Scheuermaier, K.
ORCID
Scheuermaier, K.
Venue
Brain, Behavior, and Immunity
Publisher
Elsevier BV
Published
2018-03
Volume
69
Pages
548-555
ISSN
0889-1591 (ISSN-L)
DOI
10.1016/j.bbi.2018.02.002
OpenAlex
W2793918122
Cited by
62
References
60
Citations by year
2026: 6 · 2025: 7 · 2024: 7 · 2023: 9 · 2022: 10 · 2021: 6 · 2020: 7 · 2019: 7 · 2018: 3
FWCI
7.53
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Brain Behavior and Immunity (publishedVersion)
  • PubMed (publishedVersion)
Funders
South African Medical Research Council
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
  • Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
Keywords
sleep quality, HIV infection, immune activation, depression, pain, daytime sleepiness, antiretroviral therapy
MeSH terms
Adult, Cross-Sectional Studies, Depression, Female, Humans, Male, Middle Aged, Pain, Surveys and Questionnaires, Sleep, Sleep Wake Disorders, South Africa, HIV Infections, CD4 Lymphocyte Count

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