TY - JOUR
T1 - Cognitively Based Compassion Training for HIV Immune Nonresponders - An Attention-Placebo Randomized Controlled Trial
AU - Titanji, Boghuma K.
AU - Tejani, Mehul
AU - Farber, Eugene W.
AU - Mehta, C. Christina
AU - Pace, Thaddeus W.
AU - Meagley, Kathryn
AU - Gavegnano, Christina
AU - Harrison, Timothy
AU - Kokubun, Caroline W.
AU - Negi, Satya Dev
AU - Schinazi, Raymond F.
AU - Marconi, Vincent C.
N1 - Funding Information:
Supported by the Emory Medical Care Foundation and the Emory Center for AIDS Research (P30AI050409). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/3/1
Y1 - 2022/3/1
N2 - Objective: Chronic inflammation is associated with increased morbidity and mortality for people with HIV (PWH). Psychological stress is an important contributor to this chronic inflammation. We hypothesized that a cognitively based compassion training (CBCT) approach could reduce inflammation and psychological stress in immune nonresponder PWH. Design: An attention-placebo randomized controlled trial design to evaluate the acceptability of CBCT among PWH and its effects on key aspects of stress and immune function compared with an active-attention control group (NCT02395289). Methods: This study was conducted at an HIV clinic in Atlanta, Georgia. Eligible individuals determined by (1) adherence to antiretroviral therapy for at least a year, (2) virologic suppression; and (3) stable CD4+T-cell counts <350 cells/L were randomized in a 2:1 ratio to either CBCT or control in 2 study periods: April-May, 2016, and September-December, 2016. Psychological measures and inflammatory biomarkers associated with HIV disease progression (IL-1β, TNF-α, sCD14, IL-6, and IL-10) were obtained for all study participants at baseline and at the time of study completion. Results: We found a significant association between CBCT practice time engagement and fold reduction in IL-6 and TNF-α levels. There was no association between CBCT practice time and other biomarkers markers assessed (IL-1β, sCD14, and IL-10). These changes were coincident with significant increases in self-reported psychological well-being and HIV disease acceptance and in benefits for CBCT participants. We also observed fewer instances of virologic failure for those in the CBCT arm compared with controls. Conclusions: CBCT is a novel and feasible nonmedication-based intervention that could reduce inflammation and psychological stress in PWH.
AB - Objective: Chronic inflammation is associated with increased morbidity and mortality for people with HIV (PWH). Psychological stress is an important contributor to this chronic inflammation. We hypothesized that a cognitively based compassion training (CBCT) approach could reduce inflammation and psychological stress in immune nonresponder PWH. Design: An attention-placebo randomized controlled trial design to evaluate the acceptability of CBCT among PWH and its effects on key aspects of stress and immune function compared with an active-attention control group (NCT02395289). Methods: This study was conducted at an HIV clinic in Atlanta, Georgia. Eligible individuals determined by (1) adherence to antiretroviral therapy for at least a year, (2) virologic suppression; and (3) stable CD4+T-cell counts <350 cells/L were randomized in a 2:1 ratio to either CBCT or control in 2 study periods: April-May, 2016, and September-December, 2016. Psychological measures and inflammatory biomarkers associated with HIV disease progression (IL-1β, TNF-α, sCD14, IL-6, and IL-10) were obtained for all study participants at baseline and at the time of study completion. Results: We found a significant association between CBCT practice time engagement and fold reduction in IL-6 and TNF-α levels. There was no association between CBCT practice time and other biomarkers markers assessed (IL-1β, sCD14, and IL-10). These changes were coincident with significant increases in self-reported psychological well-being and HIV disease acceptance and in benefits for CBCT participants. We also observed fewer instances of virologic failure for those in the CBCT arm compared with controls. Conclusions: CBCT is a novel and feasible nonmedication-based intervention that could reduce inflammation and psychological stress in PWH.
KW - CBCT
KW - HIV
KW - immune nonresponders
KW - inflammation
KW - mindfulness
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U2 - 10.1097/QAI.0000000000002874
DO - 10.1097/QAI.0000000000002874
M3 - Article
C2 - 34879006
AN - SCOPUS:85124606749
SN - 1525-4135
VL - 89
SP - 340
EP - 348
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 3
ER -