Self-reported health and health literacy, neuroplasticity and neuro-immunological markers during the first 12 months in newly diagnosed people living with HIV: An exploratory study.

Background: There is limited description of dynamic changes in stress, inflammation, neuroplasticity, and health literacy during the early phase of HIV infection. This study examined patterns in self-reported stress, neurobiological and neuroplastic markers during the initial 12 months of living with HIV. The study also evaluated possible changes in functional health literacy, that is, patients' ability to adhere to combination antiretroviral treatment (cART). Methods: This is an observational cohort study of one female and eleven male and patients with newly diagnosed HIV attending an urban Ryan White funded HIV clinic. Participants responded to a survey and blood was drawn at baseline, and after 1, 3, 6, 9 and 12 months, respectively. The survey measured stress, depression, and health literacy. Blood was analyzed for HIV RNA plasma viral load, CD4 cell count, and biomarkers of stress, inflammation, and neuroplasticity. Results: Viral load decreased from an initial mean count of 353,714.83 (S.E. 251,243.96) copies/mL to 24.54 (2.01) at 12 months (Wilcoxon Signed Rank Test, p = .012). CD4 cell count increased from 321.08 (48.49) to 541.13 (50.27) cells/mm Conclusion: The study confirms that during the initial 12 months living with HIV, apart from the expected improvement in viral load and CD4, there is a significant decrease in self-perceived stress, but little changes in systems inflammation. The finding of an inverse relationship between levels of a pro-inflammatory marker and health literacy requires further studies.