Correlates of anxiety in women living with HIV of reproductive age

Prior investigations suggest that women living with HIV (WLWH) experience higher rates of anxiety compared to the general population. This study investigates correlates of anxiety among 361 WLWH of reproductive age in Ontario, Canada who completed a series of self-reported measures. Anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS-A). Thirty-seven percent of the sample had high anxiety (HADS-A ≥ 11). HIV-related stigma, reproductive health-related worries, having experienced judgment from family and friends for trying to become pregnant and use of antiretrovirals were associated with high anxiety. Being in a romantic/sexual relationship, older age, and undetectable viral load were associated with low anxiety. Findings highlight the importance of HIV-related stigma and having experienced judgment from family and friends for trying to become pregnant as important predictors of anxiety among WLWH of reproductive age. There is a need for appropriate management of anxiety and stigma for WLWH of childbearing age.</p

Gender differences in severity and correlates of depression symptoms in people living with HIV in Ontario, Canada

This study investigates the differences in severity and correlates of depression symptoms among 1069 men and 267 women living with HIV in Ontario, Canada, who completed the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Women had higher CES-D scores than that of men (median [interquartile range]: 13 [5-26] versus 9 [3-20], P =.0004). More women had total CES-D scores >15 (mild-moderate depression; 44% versus 33%, P =.002) and >21 (severe depression; 31% versus 23%, P =.003). Unlike men, at age 40, women's scores increased yearly (0.4 per increased year, P =.005). The distribution of scores differed by gender: There was no difference in the 10th percentile of depression scores, 0 (95% confidence interval [CI]: 1.0-1.0) but the 75th percentile of depression scores for women was 6 (95% CI: 2.0-10.0) points higher than that of men. Important gender differences exist in depression symptoms and in correlates of symptoms in people living with HIV

Gender Differences in Severity and Correlates of Depression Symptoms in People Living with HIV in Ontario, Canada

This study investigates the differences in severity and correlates of depression symptoms among 1069 men and 267 women living with HIV in Ontario, Canada, who completed the 20-item Center for Epidemiologic Studies Depression Scale (CES-D). Women had higher CES-D scores than that of men (median [interquartile range]: 13 [5-26] versus 9 [3-20], P = .0004). More women had total CES-D scores &gt;15 (mild-moderate depression; 44% versus 33%, P = .002) and &gt;21 (severe depression; 31% versus 23%, P = .003). Unlike men, at age 40, women’s scores increased yearly (0.4 per increased year, P = .005). The distribution of scores differed by gender: There was no difference in the 10th percentile of depression scores, 0 (95% confidence interval [CI]: 1.0-1.0) but the 75th percentile of depression scores for women was 6 (95% CI: 2.0-10.0) points higher than that of men. Important gender differences exist in depression symptoms and in correlates of symptoms in people living with HIV. </jats:p

Prognostic Factors and Response Duration in 419 MDS Treated with Erythropoietin±GCSF: The GFM Experience.

Abstract Background: EPO and its derivative darbepoietin alfa (DAR) are important treatments of anemia in lower risk MDS. Prognostic factors of response and of its duration have been recently updated (Blood, 2005, 106, 803–11) and we reanalyzed them in a large series of patients (pts) treated in France and Belgium. Patients: 419 MDS pts were treated with EPO (≥30000UI/wk for at least 12 wks) or DAR (300μg/wk)± GCSF in 25 GFM centers between 1998 and 2006 (160 prospectively analyzed in 3 consecutive trials, and 259 retrospectively analyzed). Median follow-up was 54 months, median age: 73.5 years. WHO classification: RA (14%), RCMD (16%), 5q- syndrome (4%), RARS (21%) RCMD-RS (13%), RAEB-1 (22%), RAEB-2 (6%), and also 4%CMML (FAB); karyotype: 64% FAV, 16% INT, and 4% UNFAV (16% failure or not done). IPSS: 34% LOW, 40% INT-1, 8% INT-2, 2% HIGH (16% unavailable). 185, 126, 80 and 28 pts received EPO alone (alfa or beta), DAR, EPO+G and DAR+G respectively. Median pre-treatment EPO level was 76 UI/l (only 7% pts&gt;500 UI/l). All pts had Hb&lt;10g/dl and 54% required RBC transfusions (including 36% with &gt;2 RBC units/month). Results: 63% pts responded (IWG criteria: 43%HI-E major and 20% HI-E minor), including 57%, 63%, 57%, 66%, 63% with EPO alfa alone, beta alone, EPO+G, DAR alone, DAR+G response (p=ns). Median response duration was 20 mos (range 3–74 mos), 25 and 14 mos for major and minor responses (p= 0.001). Relapse was associated with treatment discontinuation (45%), progression to higher grade MDS (12%) or AML (13%), but without evident cause in 30% cases. In univariate analysis, significantly higher response rates were observed in pts with &lt;10% blasts (p= 0.002), low and INT-1 IPSS score (p=0.001), transfusion &lt;2 RBC units/month (p&lt;0.0001), EPO level&lt;200UI/l (p&lt;0.0001) whereas no significant difference in response rate were seen between RA (69%,) RCMD (72%), RARS (59%), RCMD-RS (71%), RAEB-1 (60%) and 5q- syndrome (52%), and between cytogenetic groups. The response rate in RARS and RCMD-RS was similar with EPO or DAR alone (62.5%), and EPO or DAR+G (60%). In multivariate analysis, EPO &lt;200UI/l (p=0.008), transfusion requirement (p&lt;0.0001) and IPSS (p=0.047) remained predictive factors of response. Longer response duration was significantly associated with blasts&lt;10% (20 mos vs 8 mos for blasts&gt;10%, p=0.007), major response (vs minor), IPSS low-INT-1 (median 22 mos vs 8 mos for INT-2/HIGH, p=0.001) and in pts with absence of multilineage dysplasia (24 mos vs 16 mos, p=0.01). In multivariate analysis, blasts &lt;10% and major response remained predictive factors of longer response. Conclusions: EPO level &lt;200UI/l, RBC transfusions &lt;2 units/month were confirmed as major prognostic factors of response to EPO±G. Good response rates were seen in RAEB-1, and with EPO alone, in RARS and RCMD-RS. Multilineage dysplasia was not associated with lower response rates, but with shorter response duration. Other prognostic factors of shorter response duration were minor response (vs major), and blasts &gt;10%. A case control study with pts of the International MDS risk Analysis Workshop, who received RBC transfusion alone, is in progress to evaluate the impact of EPO treatment on leukemia-free survival and overall survival, and its results will be presented.</jats:p

Predictive factors of response and survival in myelodysplastic syndrome treated with erythropoietin and G-CSF: The GFM experience

info:eu-repo/semantics/publishe