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Evidence summaries

Efficacy of Antidepressant Medication Among HIV-Positive Individuals with Depression

Antidepressant medication appears to be efficacious in treating depression in out-patient men who are HIV-positive. Level of evidence: "B"

A systematic review 1 including 7 studies with a total of 494 subjects was abstracted in DARE. Women and ethnic minorities were under-represented in the included studies, so the conclusions cannot be generalised to all depressed individuals who are HIV-positive. When using the random-effects model, the pooled effect size from all of the included RCTs was 0.57 (95% CI: 0.28 to 0.85). Analysis of potential moderators using meta-regression suggested that the only significant moderator was placebo response, which explained 61.6% of the variance (p=0.004). When the studies were stratified according to placebo response, the pooled effect size estimate was 0.80 (95% CI: 0.52, 1.08) for placebo response less than 33% and 0.20 (95% CI: -0.11, 0.52) for placebo response greater than 33%.

Comment: The quality of evidence is downgraded by heterogeneity.

    References

    • Himelhoch S, Medoff D R. Efficacy of antidepressant medication among HIV-positive individuals with depression: a systematic review and meta-analysis. AIDS Patient Care and STDs 2005; 19(12): 813-822. [DARE]

Primary/Secondary Keywords