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June 8, 1994

Depression and CD4 Decline-Reply

Author Affiliations

The Johns Hopkins Hospital Baltimore, Md

JAMA. 1994;271(22):1743-1744. doi:10.1001/jama.1994.03510460035024

In Reply.  —We found depressive symptoms did not affect time to acquired immunodeficiency syndrome (AIDS) or time to death in HIV-infected homosexual men as did our San Francisco colleagues.1 In their present letter, Dr Barrett and colleagues assert we failed to observe, as they did, an effect of depression on CD4 decline because our participants had low baseline CD4 cell counts. We replicated their analysis splitting our cohort around the median baseline CD4 cell count reported in their letter (0.621×109/L). Using this dichotomization, the "higher" baseline CD4 group had a mean baseline CD4 cell count of 0.870×109/L. Mean annual CD4 decline was -0.068×109/L for the 104 depressed respondents vs -0.072×109/L for the 422 nondepressed subjects in this group (P=.57). The "lower" baseline CD4 group had a mean baseline CD4 cell count of 0.434×109/L. The mean annual CD4 decline

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