Clinical and Diagnostic Laboratory Immunology, May 1998, p. 382-391, Vol. 5, No. 3
1071-412X/98/$04.00+0
Copyright © 1998, American Society for Microbiology. All rights reserved.
Departments of Psychiatry and Behavioral Sciences,1 Neurology,2 Psychology,3 Medicine,4 Microbiology and Immunology,5 and Epidemiology and Public Health,7 Retrovirology Laboratory,8 and Emmanuel Papper Clinical Immunology Laboratory,6 University of Miami School of Medicine, Miami, Florida
Received 18 August 1997/Returned for modification 10 December 1997/Accepted 9 February 1998
A randomized, controlled, clinical trial was conducted to examine
the impact of a semistructured, 10-week, once weekly, 90-min/session bereavement support group intervention on immunological,
neuroendocrine, and clinical health status in human immunodeficiency
virus type 1-seropositive (HIV-1+) and HIV-1-seronegative
(HIV-1
) homosexual men, compared to a standard of care
control condition. A total of 119 homosexual men (74 HIV-1+
and 45 HIV-1
) were assessed at baseline, 10 weeks, and 6 months follow-up. At the 6-month follow-up assessment, the intervention
groups exhibited significant beneficial effects compared to controls on
changes in CD4 cell, total T-lymphocyte, and total lymphocyte counts, when baseline levels, antiretroviral medication use, CDC stage of
disease, and other potentially confounding factors were accounted for.
There was no statistically significant effect on the CD4/CD8 ratio or
on the CD8 cell count. The effect on CD4 cell count was associated with
group attendance and with changes in plasma cortisol level. Plasma
cortisol levels decreased significantly among intervention subjects,
compared to controls. A significantly reduced number of health care
visits over the 6-month follow-up period among the intervention
subjects supported the clinical relevance of the immunological changes
observed for both HIV-1+ and HIV-1
individuals. These results indicate that behavioral interventions may
have salutary immunological and clinical health effects following bereavement among HIV-1-infected individuals. The effect in
HIV-1
individuals suggests that this bereavement support
group intervention might have similar salutary effects in the general
population. Potential effects of such interventions on clinical HIV
disease progression are of interest and should be studied.
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