(P09-009-25) Oxidative Stress Levels and Depressive Symptoms Among Minority Groups With HIV: A Focus on the Administration of Atypical Antipsychotics (AAP) in a Longitudinal Study.

Objectives: The risk of depression is high among African Americans due to a potential link with genetic variations in glutathione synthesis, associated with oxidative stress and depressive symptoms. Psychiatric medications such as Atypical Antipsychotics (AAP) reduce glutathione levels over time, thus diminishing the effectiveness of the medication. The objective of this study is to examine glutathione levels (total, reduced) over time in People Living with HIV (PLWH) with depressive symptomatology, comparing those taking AAP to those that are not taking AAP.

Methods: This longitudinal study using the Miami-Adult Studies in HIV (MASH) cohort analyzed baseline and 12-month visits. All participants took the same antiretroviral medication and were virally suppressed. Some of the depressed participants took AAP (Quetiapine, Aripiprazole, Olanzapine, Lurasidone, Risperidone, Clozapine, Haloperidol). Structured interviewer-assisted questionnaires included demographics, chronic conditions, smoking, depression scale (CES-D), and substance use. Glutathione and inflammation biomarkers were determined in blood samples. Data was stratified by race and AAP, and the analyses used ANCOVA, adjusting for age and inflammation markers.

Results: A total of 94 participants were included in the study: 67 identified as African American, and 27 as Whites. The average age was 52.8 years, and the mean BMI was 28.8 kg/m2 ± 6.2 SD.  African Americans had higher rates of severe depressive symptoms than Whites (19.1% vs 10.0%, respectively, p=0.03). Among participants with severe depressive symptoms taking AAP, African Americans lowered their total and reduced glutathione levels over 12 months by 287.9 µM (p = 0.04) and 223.3 µM (p=0.04, respectively) compared to the White race. White with severely depressed symptomatology not taking AAP had a significant difference in total and reduced glutathione at 12 months with an increase of 604.0 µM (p = 0.01) and 569.1 µM (p= 0.02), respectively, than severely depressed African Americans not taking AAP.

Conclusions: AAP is an essential medication for the management and control of depressive symptomatology. However, long-term treatments must be closely monitored, as antioxidant status may be adversely affected in PLWH, particularly within the African American population.

Funding Sources: National Insitute on Drug Abuse ( NIDA)