Psychoneuroimmunology and HIV

Phil KucabMind-Body Medicine

A brief look at

the psyche, the neuroendocrine system and the immune system

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HIV and stress = 2068

The goal isto stay as

healthy as possible

as long as possible

Viral Load

CD4+ T-Cell Count

How do we measure health status in

HIV positive people?1

= speed of train

= track remaining

Finding out you are

HIV positive is stressful 7

more rapid HIV progression?Is depression associated with

be depressedLyketsos, JAMA, 1993

were more likely toMen with more symptoms

38% greater loss

Burack, JAMA, 1993

of CD4+ T-cells/year

Progression to AIDSAIDS and

StressfulStressful Life Events.8

Is there a ?basisbiological

“Slow HIV progression is

CCR5 receptor density.”correlated with low

10

“norepinephrine enhanced replication of both CCR5 in vitro via chemokine receptor up-regulation and enhanced viral gene expression”3

by stress,

“To the extent that one’s medical condition and/or symptoms are caused or made worse

we can help.”

Herbert Benson, MDBenson-Henry Institute for Mind-Body Medicine

Most frequently used alternative and

complementary therapies5

Non-exerciseNon-exercise control showed control showed

significant increases in significant increases in anxiety anxiety and depressionand depression as well as as well as

decreases in their decreases in their NK cell countNK cell count55

Those in the exercise exercise treatment group treatment group showed no similar changes and showed a

significant increase in

CD4+ Lymphocyte levels.55

Prayer has been clinically examined in an HIV-negative cohort with regard to self-esteem, anxiety, depression

and showed significant improvement in 11 outcome measures. (O’Laire, 1997)

The majority HIV+ participants increase their practice of prayer since their HIV diagnosis.

5

Massage boosts immune system function by:

• Reducing anxiety and stress• Increasing white blood cell counts• Decreasing levels of cortisol • Activating natural killer cells

Reframing challenges may not change reality, but it

can change attitude.