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Association Between Alcohol Use, CD4 Count, and Depressive Symptoms Among People with HIV with Viral Load Suppressed

Alain Favina1,2, Robin Fatch3, Sowmya R Rao4,5

  • 1Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.

AIDS and Behavior
|July 21, 2026
PubMed

Insights

Depression is common in people with HIV (PWH) on effective treatment. This study found no link between CD4 cell count and depressive symptoms, nor did alcohol use modify this relationship in Ugandan PWH.

Area of Science:

  • HIV/AIDS Research
  • Mental Health
  • Immunology

Background:

  • Depression is a significant mental health issue for people with HIV (PWH) globally, even with effective antiretroviral therapy (ART) and viral suppression.
  • Understanding factors associated with depression in PWH is crucial for improving care and outcomes.

Purpose of the Study:

  • To investigate the association between CD4 cell count and depressive symptoms in PWH on ART with viral suppression.
  • To examine whether alcohol use modifies the relationship between CD4 cell count and depressive symptoms.

Main Methods:

  • A combined analysis of baseline data from two longitudinal studies (DIPT and ADEPTT) in Southwestern Uganda (May 2017 - August 2021).
  • Included adults with suppressed HIV viral load, assessing depressive symptoms via the CESD Scale.
  • CD4+ count and alcohol use (AUDIT-C, PEth biomarker) were measured. Multivariable mixed effects logistic regression was used.

Main Results:

  • Among 908 participants, 14.6% experienced depressive symptoms. Median CD4 count was 632 cells/mm³.
  • No significant association was observed between CD4 cell count and depressive symptoms (aOR: 1.04; p=0.26).
  • Alcohol use did not significantly modify the relationship between CD4 count and depressive symptoms (p=0.10).

Conclusions:

  • Depressive symptoms are highly prevalent in PWH with viral suppression, indicating a need for clinical attention.
  • Current CD4 cell count and alcohol consumption levels do not appear to be significant correlates of depression in this population.
  • Further research is needed to identify underlying causes and develop targeted interventions for depression in PWH.

Keywords:
Alcohol useCD4 countDepressionHIV viral suppressionPeople with HIV (PLHIV)

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