Stress ‘Undermines’ Drug Therapy in Those With HIV, Increases Viral Replication

Elevated levels of stress in HIV-positive individuals may facilitate viral replication and "undermine" the effectiveness of drug treatment, according to a study published in the Oct. 23 issue of the Proceedings of the National Academy of Sciences, Reuters Health reports. Researchers from the University of California-Los Angeles measured the viral loads and CD4 cell counts of 13 HIV-positive men between the ages of 25 and 54 who had never used combination drug therapy. To evaluate autonomic nervous system activity, which tends to be higher in people prone to stress, the researchers measured blood pressure, skin moisture, heart rate and resting pulse rate. The men then began combination therapy, and researchers retested all indicators six months after treatment was initiated. Men who were less inclined to experience stress had declines in viral load four times greater than those who were stressed. Their CD4 cell counts also increased from 396 to 551 on average, while the stressed men experienced an average increase from 611 to 627. The researchers also exposed T cells to norepinephrine -- a hormone released when the body is under stress -- in the lab and found that HIV replication was increased 10-fold after exposure to the hormone. According to co-author Dr. Steven Cole, the findings indicate not only that "[h]igh stress levels can undermine the benefits of drugs," but that "biochemicals released by stress can alter the activity of the molecules that navigate immune cells to sites of infection within the body." The findings might also apply to other diseases like flus and colds, he added. So far, researchers have experienced "mixed results" when attempting to lower stress in HIV patients through stress-reduction techniques. Cole's team has begun investigating the stress-lowering effects of beta-blockers in HIV patients and should have preliminary results "within a year" (McKinney, Reuters Health, 10/24).