Email updates

Keep up to date with the latest news and content from BMC Complementary and Alternative Medicine and BioMed Central.

This article is part of the supplement: Scientific Abstracts Presented at the International Research Congress on Integrative Medicine and Health 2012

Open Access Oral presentation

OA02.02. Effect of MBSR and psychological state on inflammatory markers in HIV positive adults

E Weston1*, P Moran1, M Acree1, J Moskowitz1, M Kemeny2, E Elissa2, P Bacchetti3, K Barrows1, S Deeks4 and F Hecht1

  • * Corresponding author: E Weston

Author Affiliations

1 University of California, San Francisco (UCSF), Osher Center for Integrative Med, San Francisco, USA

2 Department of Psychiatry, UCSF, San Francisco, USA

3 Department of Epidemiology and Biostatistics, UCSF, San Francisco, USA

4 Department of Medicine, UCSF, San Francisco, USA

For all author emails, please log on.

BMC Complementary and Alternative Medicine 2012, 12(Suppl 1):O6  doi:10.1186/1472-6882-12-S1-O6

The electronic version of this article is the complete one and can be found online at: http://www.biomedcentral.com/1472-6882/12/S1/O6


Published:12 June 2012

© 2012 Weston et al; licensee BioMed Central Ltd.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose

HIV induces a pro-inflammatory response that is linked to increased morbidity and mortality. Stress and depression have been associated with elevated inflammation. We sought to test whether Mindfulness Based Stress Reduction (MBSR) would improve high sensitivity C-reactive protein (hsCRP) and D-dimer in HIV+ adults, and to explore the cross-sectional and longitudinal relationships between psychological state and these markers.

Methods

We randomized antiretroviral-untreated HIV+ adults with CD4+ counts >250 cells/µl to MBSR or an education/support control group. Baseline, 3, and 12 month measures included: Perceived Stress Scale (PSS), Beck Depression Inventory (BDI), Patient Health Questionnaire-9 (PHQ), State Trait Anxiety Inventory (STAI), and Positive and Negative Affect Scale (PANAS+/-). Data were censored for starting antiretroviral therapy during follow-up.

Results

Of 177 participants, 132 (71 MBSR, 61 control) had complete specimen panels and were eligible for this sub-study. MBSR did not appear to have a substantial effect on change in hsCRP or D-dimer from baseline to 3, or 12 months (p>0.10), though CIs were wide. hsCRP at baseline was positively correlated with: PSS (β=0.18, p=0.034), BDI (β=0.21, p=0.014), PHQ (β=0.15, p=0.087), PANAS+/- (β=0.17, p=0.049), and STAI (β=0.19, p=0.030). hsCRP was correlated with BMI (β=0.25, p=0.004). After controlling for BMI, age, and viral load, hsCRP remained associated with BDI (β=0.19 p=0.03) and STAI (β=0.16 p=0.065). D-dimer showed no substantial baseline correlation with any scale (β<0.1, p>0.5). No substantial longitudinal relationships were found between change in hsCRP or D-dimer and change in any psychological measure (β<0.12, p>0.2).

Conclusion

MBSR did not appear to substantially improve hsCRP or D-dimer. Correlations between hsCRP and psychological measures were in hypothesized directions. The observation that hsCRP was associated with depression in multivariate analysis suggests a causal association between these processes. Interventional studies aimed at reducing inflammation, or improving mood, are needed to clarify this association and to identify future therapeutic strategies.