A Influência do Estresse Psicológico na Progressão e Evolução do HIV: Uma Revisão Sistemática
DOI:
https://doi.org/10.36489/saudecoletiva.2025v16i98p16716-16731Palavras-chave:
HIV/AIDS, Estresse, Sistema Imune, Revisão SistemáticaResumo
A pesquisa foi realizada através de uma revisão sistemática de estudos publicados entre 1990 e 2024, utilizando as bases de dados Pubmed, Science Direct e Scopus, com os termos de busca "HIV/AIDS" AND "stress" AND "immune system". Os critérios de inclusão foram: estudos em seres humanos e que avaliaram marcadores imunológicos e parâmetros de estresse, ansiedade e depressão. Após a triagem, 15 artigos foram incluídos nesta revisão. Os resultados mostram que o estresse psicológico, principalmente quando relacionado à ansiedade e depressão, afeta negativamente o sistema imunológico, acelerando a progressão da infecção por HIV. Todavia, intervenções como terapia emocional e prática regular de atividades físicas demonstraram ser eficazes na homeostase do sistema imunológico. Conclui-se que o estresse tem uma influência direta na progressão da infecção por prejudicar a resposta imune, a inclusão de intervenções psicossociais é fundamental para melhorar a qualidade de vida e retardar a evolução da doença
Referências
McIntosh R, et al. Medial prefrontal cortex connectivity with the nucleus accumbens is related to HIV serostatus, perceptions of psychological stress, and monocyte expression of TNF-a. Brain Behav Immun Health. 2024;41:100844.
Bekker LG, Hosek S, Laga M, Beyrer C. HIV infection. Nat Rev Dis Primers 2023; 9(1):42.
Battistini Garcia SA, Guzman N. Acquired immune deficiency syndrome CD4+ count. Treasure Island (FL): StatPearls Publishing; 2023 [citado 2025 jan 30]. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK513289/
Silvério, R. F. L. Cuidado às pessoas vivendo com HIV na atenção especializada: uma análise à luz da vulnerabilidade programática. 2023. 83 f. Dissertação (Mestrado em Saúde Coletiva) – Programa de Pós-Graduação em Saúde Coletiva, Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, 2023. Disponível em: https://app.uff.br/riuff/handle/1/33927. Acesso em: 25 jan. 2025.
Wong J, Sandler N, Kovacs C, Robbins G, Kamarulzaman A, Altfeld M. The many faces of immune activation in HIV-1 infection. Curr Opin HIV AIDS. 2020;15(2):113-120. Disponível em: https://journals.lww.com/co-hivandaids/Abstract/2020/03000/The_many_faces_of_immune_activation_in_HIV_1.9.aspx. Acesso em: 22 out. 2024.
Qin XM, Allan R, Park JY, Kim SH, Joo CH. Impact of exercise training and diet therapy on the physical fitness, quality of life, and immune response of people living with HIV/AIDS: a randomized controlled trial. BMC Public Health. 2024;24:730.
Ironson G, Hayward H. Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosom Med. 2008;70(5):546-554.
Variava T, Watermeyer J. A systematic review exploring the psychosocial factors affecting adolescent access to HIV treatment services. Adolescents. 2022;3(1):10-40.
Hantsoo L, Hiles S, Eisenberger NI, Kiecolt-Glaser JK, Hagan K, Miller GE, Slusher AL, Boulware D, Carpenter L, Hudson P, Baker A, et al. Glucocorticoid–immune response to acute stress in women and men living with HIV. J Behav Med. 2019;42(6):1153-1158.
Rao D, Melendez-Torres GJ, John N, Perea-Burns S, Stein D, Lichtenstein B, Onorato N, Baral S. Gender differences in HIV risk and stigma: implications for prevention and treatment. J Acquir Immune Defic Syndr. 2015;68(Suppl 0):S100-S107.
Carr D, Smith A, Jones B. Chronic inflammation, immune metabolism, and T cell dysfunction in HIV infection. Front Immunol 2019; 10:85. Disponível em: https://www.frontiersin.org/articles/10.3389/fimmu.2019.00085/full. Acesso em: 22 out. 2024.
Page MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;371:n71.
Kessler RC, Liu H, Kandel DB, Wang PS, Collins R, Tennen H, McLaughlin KA, Batten SV, Merikangas KR. Stressful life events and symptom onset in HIV infection. Am J Psychiatry. 1991;148(6):733-738.
Julnes PS, McDonald R, Schwabe C, Bianchi S, Berini C, Williams L, Klein L, Kaufman B, Gelman E, Lightman S, et al. The association between post-traumatic stress disorder and markers of inflammation and immune activation in HIV-infected individuals with controlled viremia. Psychosomatics. 2016;57(4):423-430.
Solomon GF, et al. Psychoneuroimmunology of health and long survival with HIV/AIDS: questionnaires, semistructured interviews, and laboratory findings. Int Congr Ser. 2002;1278:27-30.
Fumaz CR, et al. Psychological stress is associated with high levels of IL-6 in HIV-1 infected individuals on effective combined antiretroviral treatment. Brain Behav Immun. 2012;26(4):568-572.
Leserman J, Petitto JM, Gaynes BN, DeMasi R, Pacht E, McCutchan JA, McGwin G, McDaniel JS, McArthur J, McDonnell JJ, Waters D, et al. Progression to AIDS, a clinical AIDS condition and mortality: psychosocial and physiological predictors. Psychol Med. 2002;32(6):1059-1073.
Cole S, Kemeny M, Taylor S, Visscher B. Stress accelerates AIDS progression, undermines the effect of anti-HIV drugs. J Assoc Nurses AIDS Care 2002; 13(2):85.
Greeson JM, Batchelder AW, Safren SA, Leserman J, Pence BW, Hinkin CH, Ickovics JR, Ironson G, Schneiderman N, Costa PT, Miller EN. Psychological distress, killer lymphocytes, and disease severity in HIV/AIDS. Brain Behav Immun. 2008;22(6):901-911.
Rendina HJ, Siconolfi D, Tindle HA, Reilly ED, Grov C, Parsons JT, Karpiak SE. Psychosocial well-being and HIV-related immune health outcomes among HIV-positive older adults: support for a biopsychosocial model of HIV stigma and health. J Int Assoc Provid AIDS Care. 2019;18:1-11.
Birk TJ, McGrady A, MacArthur RD, Khuder SA. The effects of massage therapy alone and in combination with other complementary therapies on immune system measures and quality of life in human immunodeficiency virus. J Altern Complement Med 2000; 6(5):405-414.
Laperriere AR, et al. Exercise intervention attenuates emotional distress and natural killer cell decrements following notification of positive serologic status for HIV-1. Biofeedback Self Regul. 1990;15(3):229-242.
Corroon J, McGee M, Zajicek J, Percival SS. Pilot clinical trial of constitutional hydrotherapy in HIV+ adults. Adv Integr Med. 2018;5(1):23-28.
Mustafa T, et al. Association between exercise and HIV disease progression in a cohort of homosexual men. Ann Epidemiol. 1999;9(2):127-131.
Ghayomzadeh M, et al. Effect of a short-term lifestyle modification program on quality of life, anthropometric characteristics and CD4+ T cell count of HIV-infected patients in Tehran/Iran: a randomized controlled trial. Explore. 2019;15(4):308-315.
O'Cleirigh C, Safren SA, Mayer KH, Skeer M, Taylor S, Gifford AL, Safren M, Gebo KA. Written emotional disclosure and processing of trauma are associated with protected health status and immunity in people living with HIV/AIDS. Br J Health Psychol. 2008;13(1):81-84.
Alotiby A. Immunology of stress: a review article. J Clin Med [Internet]. 2024 [citado 2025 fev 3];13(21):6394.
Kołodziej J. Effects of stress on HIV infection progression. HIV AIDS Rev. 2016;15(1):13-16.
Costa LF, Jesus Medeiros R, Paungartner LM, Luft TD, Santos AP, Paiva TS, Fernandes MTC. Fatores psicossociais envolvidos na adesão ao tratamento do HIV/AIDS em adultos: revisão integrativa da literatura. Saúde Coletiva (Barueri), 2021; 11(61):4990-5005.
Calvetti PU, Müller MC, Nunes MLT, Bandeira DR. Fatores psicossociais associados à adesão ao tratamento e qualidade de vida em pessoas vivendo com HIV/AIDS no Brasil. J Bras Psiquiatr. 2014;63(1):8-15.
Gonzalez JS, Batchelder AW, Psaros C, Safren SA. Sex differences in the psychosocial impact of HIV disease. Curr HIV/AIDS Rep. 2011;8(4):236-242.
HIV.gov. Early antiretroviral therapy prevents non-AIDS outcomes in HIV-infected people. HIV.gov. 2015. Disponível em: https://www.hiv.gov/blog/early-antiretroviral-therapy-prevents-non-aids-outcomes-in-hiv-infected-people. Acesso em: 22 out. 2024.
