By Marilyn Elias, USA TODAY
Budapest, Hungary, USA Today, Tuesday, March 13, 2007 — HIV patients live longer if they face stress by venting their feelings, taking a realistic view of threats to their health and keeping a sense of self-worth, a study suggested over the weekend.
The findings add to growing evidence that how HIV-positive patients cope with their trauma can affect how rapidly the disease progresses. The study on 174 men and women was reported at the American Psychosomatic Society meeting here.
Participants were asked at the start to write an essay describing their emotional responses to a traumatic life event. Most wrote about HIV problems. Their blood was drawn to measure virus-fighting CD-4 cells and viral load; CD-4 cells decline and viral load increases as HIV progresses. Then blood was redrawn every six months for four years.
Researchers who didn't know the patients' blood results analyzed their essays for four qualities:
Researchers took into account patients' disease stage, medications, education and other things that could affect HIV progression, says psychologist Conall O'Cleirigh of Harvard University School of Medicine. He reported on the study with co-author Gail Ironson of University of Miami.
Patients who handled stress in emotionally healthy ways did better at fending off HIV, O'Cleirigh says. The better their coping methods at the start, the slower their decline of virus-fighting cells and the less HIV in their blood, he says.
Patients who aren't into avoidance or are not paralyzed by stress may be more likely to find a good doctor and take their medicines, O'Cleirigh says. So that could improve the prognosis. Such patients "also may reap benefits to their immune system because they're coping well with stress," he adds. The stress hormone cortisol, for example, hampers the immune system, and patients who cope well may have less cortisol.
"We don't know exactly how these emotions work to affect illness," says Susan Folkman, director of the Osher Center for Integrative Medicine at University of California-San Francisco Medical School. "But I don't think we're talking magic. … It's probably a combination of behaviors that might slow progression and effects on the immune system from the emotions."
A key implication is that doctors should be examining how HIV patients are dealing with stress, O'Cleirigh says. Those who have a hard time should be referred for counseling that teaches better coping methods, such as cognitive-behavior therapy, he says.
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