Effect of Integrated Yoga (IY) on Psychological States and CD4 Counts of HIV-1 Infected Patients: A Randomized Controlled Pilot Study

By Naoroibam, Rosy; Metri, Kashinath et al. | International Journal of Yoga, January-June 2016 | Go to article overview

Effect of Integrated Yoga (IY) on Psychological States and CD4 Counts of HIV-1 Infected Patients: A Randomized Controlled Pilot Study


Naoroibam, Rosy, Metri, Kashinath, Bhargav, Hemant, Nagaratna, R., Nagendra, H., International Journal of Yoga


Byline: Rosy. Naoroibam, Kashinath. Metri, Hemant. Bhargav, R. Nagaratna, H. Nagendra

Background: Human immunodeficiency virus (HIV) infected individuals frequently suffer from anxiety and depression. Depression has been associated with rapid decline in CD4 counts and worsened treatment outcomes in HIV-infected patients. Yoga has been used to reduce psychopathology and improve immunity. Aim: To study the effect of 1-month integrated yoga (IY) intervention on anxiety, depression, and CD4 counts in patients suffering from HIV-1 infection. Methods: Forty four HIV-1 infected individuals from two HIV rehabilitation centers of Manipur State of India were randomized into two groups: Yoga (n = 22; 12 males) and control (n = 22; 14 males). Yoga group received IY intervention, which included physical postures (asanas), breathing practices (pranayama), relaxation techniques, and meditation. IY sessions were given 60 min/day, 6 days a week for 1 month. Control group followed daily routine during this period. All patients were on anti-retroviral therapy (ART) and dosages were kept stable during the study. There was no significant difference in age, gender, education, CD4 counts, and ART status between the two groups. Hospital anxiety and depression scale was used to assess anxiety and depression, CD4 counts were measured by flow cytometry before and after intervention. Analysis of variance – repeated measures was applied to analyze the data using SPSS version 10. Results: Within group comparison showed a significant reduction in depression scores (F [1, 21] =4.19, P < 0.05) and non-significant reduction in anxiety scores along with non significant increment in CD4 counts in the yoga group. In the control group, there was a non-significant increase in anxiety and depression scores and reduction in CD4 counts. Between-group comparison revealed a significant reduction in depression scores (F [1, 21] =5.64, P < 0.05) and significant increase in CD4 counts (F [1, 21] =5.35, P < 0.05) in the yoga group as compared to the control. Conclusion: One month practice of IY may reduce depression and improve immunity in HIV-1 infected adults.

Introduction

Human immunodeficiency virus (HIV) infection is a communicable disease leading to significant morbidity, mortality, and poor quality of life. Approximately, 2.5 million individuals were found to be infected with HIV-1 infection in the 2009 survey. Though anti-retroviral therapy (ART) has significantly increased the life span and treatment outcome in HIV-infected patients, social stigma, depression, substance abuse, and wrong cultural beliefs significantly impair their quality of life.[sup][1] Mental disorders such as major depressive disorder, generalized anxiety, and agoraphobia are commonly found in patients with HIV.[sup][2] Out of all these, depression is the most prevalent comorbid mental disorder with a prevalence of 22–38% among HIV-infected patients.[sup][3],[4],[5] Unemployment, lack of health insurance, low CD4+ cell counts, not having a partner, and poor quality of social support are significant contributors for depression in HIV-infected patients.[sup][6] Depression is found to be associated with poor adherence to ART,[sup][7] and also influences CD4 counts and viral loads (VLs) negatively.[sup][8] Antidepressant medications are helpful, but they are not free from side effects.

Complementary and alternative medicine is becoming popular as rehabilitation measures in patients living with HIV/AIDS.[sup][9] Yoga is the most commonly used mind–body intervention.[sup][10] It is cost-effective and easy to implement and offers benefit for emotional, psychological, and physical health.[sup][11] Yoga encompasses asanas (Yogic postures), pranayama (Yogic breathing practices), yoga-based relaxation techniques, and meditation.

Many studies demonstrated the broad positive impact of yoga in health and many disease conditions. …

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