Comparación psiconeuroinmunológica de hombres que tienen sexo con hombres con diferentes comportamientos de riesgo sexual

Contenido principal del artículo

Jorge Emiro Restrepo
Wildeman Zapata
Ana Claudia Ossa Giraldo
Gina Paula Cuartas Montoya

Resumen

El objetivo de este estudio fue analizar si existen diferencias emocionales, de personalidad, neuropsicológicas, neurobiológicas e inmunológicas entre hombres que tienen sexo con hombres con comportamientos sexuales de bajo y alto riesgo, aplicando  metodologías y teorías de ciencias del comportamiento, neurociencias y procedimientos tradicionales en el ámbito celular y  molecular con una cohorte de 30 participantes VIH negativos de Medellín, Colombia. Los participantes se clasificaron en dos grupos según la frecuencia de las parejas sexuales en los últimos tres meses. Resultados: El principal hallazgo de este estudio fue haber  detectado algunas diferencias psicológicas entre dos grupos. La depresión, el estrés y el neuroticismo mostraron diferencias entre el grupo de alto riesgo y el grupo de bajo riesgo. Ninguna de las otras variables psicológicas, neuropsicológicas, neurobiológicas o inmunológicas mostró diferencias entre los grupos. Conclusiones: se identificaron ciertas carácterísticas psicológicas que  diferenciaron a ambos grupos (particularmente la emocionalidad negativa), pero no hubo diferencias en los perfiles  neuropsicológicos o inmunológico.

Palabras clave:
Psiconeuroinmunología VIH Depresión estr´és Neuroticismo

Citas

Ahaneku, H., Ross, M. W., Nyoni, J. E., Selwyn, B., Troisi, C., Mbwambo, J., Adeboye, A., & McCurdy, S. (2016). Depression and HIV risk among men who have sex with men in Tanzania. AIDS care, 28, 140-147. https://doi.org/10.1080/09540121.2016.1146207

Aluja, A., Blanch, A., Sole, D., Dolcet, J.-M., & Gallart, S. (2009). Versiones cortas del NEO-PI-R: el NEO-FFI frente al NEO-FFI-R. Behavioral Psychology/Psicologia Conductual, 17(2), 335-350.

Baral, S., Sifakis, F., Cleghorn, F., & Beyrer, C. (2007). Elevated Risk for HIV Infection among Men Who Have Sex with Men in Low- and Middle-Income Countries 2000–2006: A Systematic Review. PLoS Medicine, 4(12), e339. https://doi.org/10.1371/journal.pmed.0040339

Beck, A., Steer, R., & Brown, G. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.

Beck, A.T., & Steer, R. A. (1993). BAI: Beck Anxiety inventory: manual. San Antonio, TX: Psychological Corporation.

Becking, K., Haarman, B., Grosse, L., Nolen, W. A., Claes, S., Arolt, V., Schoevers, R. A., & Drexhage, H. A. (2018). The circulating levels of CD4+ t helper cells are higher in bipolar disorder as compared to major depressive disorder. Journal of Neuroimmunology, 319, 28-36. https://doi.org/10.1016/j.jneuroim.2018.03.004

Belkaid, Y., & Naik, S. (2013). Compartmentalized and systemic control of tissue immunity by commensals. Nature Immunology, 14(7), 646-653. https://doi.org/10.1038/ni.2604

Benton, T., Lynch, K., Dubé, B., Gettes, D. R., Tustin, N. B., Ping Lai, J., Metzger, D. S., Blume, J., Douglas, S. D., & Evans, D. L. (2010). Selective serotonin reuptake inhibitor suppression of HIV infectivity and replication. Psychosomatic Medicine, 72(9), 925-932. https://doi.org/10.1097/PSY.0b013e3181f883ce

Beyrer, C., Baral, S. D., Collins, C., Richardson, E. T., Sullivan, P. S., Sanchez, J., Trapence, G., Katabira, E., Kazatchkine, M., Ryan, O., Wirtz, A. L., & Mayer, K. H. (2016). The global response to HIV in men who have sex with men. Lancet, 388(10040), 198-206. https://doi.org/10.1016/S0140-6736(16)30781-4

Bokaei, P. B., Ma, X. Z., Sakac, D., & Branch, D. R. (2007). HIV-1 integration is inhibited by stimulation of the VPAC2 neuroendocrine receptor. Virology, 362(1), 38-49. https://doi.org/10.1016/j.virol.2006.12.012

Borella, P., Bargellini, A., Rovesti, S., Pinelli, M., Vivoli, R., Solfrini, V., & Vivoli, G. (1999). Emotional stability, anxiety, and natural killer activity under examination stress. Psychoneuroendocrinology, 24(6), 613-627. https://doi.org/10.1016/s0306-4530(99)00016-5

Bouhuys, A. L., Flentge, F., Oldehinkel, A. J., & van den Berg, M. D. (2004). Potential psychosocial mechanisms linking depression to immune function in elderly subjects. Psychiatry Research, 127(3), 237-245. https://doi.org/10.1016/j.psychres.2004.05.001

Bradley, M. V., Remien, R. H., & Dolezal, C. (2008). Depression symptoms and sexual HIV risk behavior among serodiscordant couples. Psychosomatic Medicine, 70(2), 186-191. https://doi.org/10.1097/PSY.0b013e3181642a1c

Brandt, C. P., Zvolensky, M. J., & Bonn-Miller, M. O. (2012). Distress Tolerance, Emotion Dysregulation, and Anxiety and Depressive Symptoms Among HIV+ Individuals. Cognitive Therapy and Research, 37(3), 446-455. https://doi.org/10.1007/s10608-012-9497-9

Centro Europeo para la Prevención y el Control de las Enfermedades. (2019). The European Men-Who-Have-Sex-With-Men Internet Survey Key findings from 50 countries. Recuperado de https://www.ecdc.europa.eu/sites/default/files/documents/European-MSM-internet-survey-2017-findings.pdf

Chinen, J., & Shearer, W. T. (2002). Molecular virology and immunology of HIV infection. The Journal of allergy and clinical immunology, 110(2), 189-198. https://doi.org/10.1067/mai.2002.126226

Cooper, M. L., Agocha, V. B., & Sheldon, M. S. (2000). A motivational perspective on risky behaviors: the role of personality and affect regulatory processes. Journal of Personality, 68(6), 1059-1088. https://doi.org/10.1111/1467-6494.00126

Corwin, E. J., Johnston, N., & Pugh, L. (2008). Symptoms of postpartum depression associated with elevated levels of interleukin-1 beta during the first month postpartum. Biological Research for Nursing, 10(2), 128-133. https://doi.org/10.1177/1099800408323220

Costa, P., & McCrae, R. (1999). Inventario de Personalidad Neo - Revisado. Madrid, España: TEA.

Cruess, D. G., Douglas, S. D., Petitto, J. M., Leserman, J., Ten Have, T., Gettes, D., Dubé, B., & Evans, D. L. (2003). Association of depression, CD8+ T lymphocytes, and natural killer cell activity: implications for morbidity and mortality in Human immunodeficiency virus disease. Current Psychiatry Reports, 5(6), 445-450. https://doi.org/10.1007/s11920-003-0083-4

Daruna, J. H. (1996). Neuroticism predicts normal variability in the number of circulating leucocytes. Personality and Individual Differences, 20(1), 103-108. https://doi.org/10.1016/0191-8869(95)00141-R

Fernández, J., & Mielgo, M. (2001). Escalas de apreciación del estrés: manual. Madrid, España: TEA.

Firoozi, M., Azmoude, E., & Asgharipoor, N. (2016). The relationship between personality traits and sexual self-esteem and its components. Iranian Journal of Nursing and Midwifery Research, 21(3), 225-231. https://doi.org/10.4103/1735-9066.180375

Fondo Colombiano de Enfermedades de Alto Costo. (2018). Situación del VIH SIDA en Colombia 2018. Recuperado de https://www.cuentadealtocosto.org/site/images/Libro_Situacion_del_VIH_SIDA_en_Colombia_2018.pdf

Friedman H. S. (2000). Long-term relations of personality and health: dynamisms, mechanisms, tropisms. Journal of Personality, 68(6), 1089-1107. https://doi.org/10.1111/1467-6494.00127

Fydrich, T., Dowdall, D., & Chambless, D. L. (1992). Reliability and validity of the Beck Anxiety Inventory. Journal of Anxiety Disorders, 6(1), 55-61. https://doi.org/10.1016/0887-6185(92)90026-4

García-Batista, Z. E., Guerra-Peña, K., Cano-Vindel, A., Herrera-Martínez, S. X., & Medrano, L. A. (2018). Validity and reliability of the Beck Depression Inventory (BDI-II) in general and hospital population of Dominican Republic. PloS one, 13(6), e0199750. https://doi.org/10.1371/journal.pone.0199750

Gaskill, P. J., Yano, H. H., Kalpana, G. V., Javitch, J. A., & Berman, J. W. (2014). Dopamine receptor activation increases HIV entry into primary human macrophages. PloS one, 9(9), e108232. https://doi.org/10.1371/journal.pone.0108232

Haapakoski, R., Mathieu, J., Ebmeier, K. P., Alenius, H., & Kivimäki, M. (2015). Cumulative meta-analysis of interleukins 6 and 1β, tumour necrosis factor α and C-reactive protein in patients with major depressive disorder. Brain, behavior, and immunity, 49, 206-215. https://doi.org/10.1016/j.bbi.2015.06.001

Hennig, J., Pössel, P., & Netter, P. (1996). Sensitivity to disgust as an indicator of neuroticism: A psychobiological approach. Personality and Individual Differences, 20(5), 589-596. https://doi.org/10.1016/0191-8869(95)00218-9

Hutton, H. E., & Treisman, G. J. (2001). Understanding the role of personality in HIV risk behaviors: implications for prevention and treatment. The Hopkins HIV report: a bimonthly newsletter for healthcare providers, 13(6), 5-7.

Johnson, J. D., Barnard, D. F., Kulp, A. C., & Mehta, D. M. (2019). Neuroendocrine regulation of brain cytokines after psychological stress. Journal of the Endocrine Society, 3(7), 1302-1320. https://doi.org/10.1210/js.2019-00053

Kemeny M. E. (1994). Psychoneuroimmunology of HIV infection. The Psychiatric clinics of North America, 17(1), 55-68.

Kim, Y. K., Suh, I. B., Kim, H., Han, C. S., Lim, C. S., Choi, S. H., & Licinio, J. (2002). The plasma levels of interleukin-12 in schizophrenia, major depression, and bipolar mania: effects of psychotropic drugs. Molecular Psychiatry, 7(10), 1107-1114. https://doi.org/10.1038/sj.mp.4001084

Koblin, B. A., Husnik, M. J., Colfax, G., Huang, Y., Madison, M., Mayer, K., Barresi, P. J., Coates, T. J., Chesney, M. A., & Buchbinder, S. (2006). Risk factors for HIV infection among men who have sex with men. AIDS, 20(5), 731-739. https://doi.org/10.1097/01.aids.0000216374.61442.55

Kryza, M. E. (2011). Perspectives of psychosomatic medicine: An integration of psychoneuroimmunology and epigenetics. Scientia Discipulorum, 5, 45-62.

Leonard, B. (2000). Stress, depression and the activation of the immune system. The world journal of biological psychiatry: the official journal of the World Federation of Societies of Biological Psychiatry, 1(1), 17-25. https://doi.org/10.3109/15622970009150562

Machado, A., Pereira, N., Tavares de Luna, R., Bastos, N., Gonçalves, A., Rodrigues da Silva, W., Sousa, F., Gonçalves, J., Souza da Cruz, L., Lóssio, C., & Rolim, M. (2015). Depression as a Risk Factor for HIV Infection. International Archives of Medicine, 8(100), 1-5. https://doi.org/doi:10.3823/1699

Mathews, H. L., & Janusek, L. W. (2011). Epigenetics and psychoneuroimmunology: mechanisms and models. Brain, Behavior, and Immunity, 25(1), 25-39. https://doi.org/10.1016/j.bbi.2010.08.009

Matsumoto, S., Yamaoka, K., Takahashi, K., Tanuma, J., Mizushima, D., Do, C. D., Nguyen, D. T., Nguyen, H., Nguyen, K. V., & Oka, S. (2017). Social Support as a Key Protective Factor against Depression in HIV-Infected Patients: Report from large HIV clinics in Hanoi, Vietnam. Scientific Reports, 7(1), 15489. https://doi.org/10.1038/s41598-017-15768-w

Ministerio de Salud y Protección Social. (2011). Estudio sobre comportamiento sexual y prevalencia de VIH en hombres que tienen sexo con hombres en siete ciudades de Colombia. Recuperado de https://www.minsalud.gov.co/salud/Documents/observatorio_vih/documentos/monitoreo_evaluacion/2_evaluacion_respuesta/b_estudios_complementarios/Resultados_Estudio_HSH_final125.pdf

Murray M. F. (2010). Insights into therapy: tryptophan oxidation and HIV infection. Science Translational Medicine, 2(32), 32-23. https://doi.org/10.1126/scitranslmed.3001082

Osborne, L. M., Gilden, J., Kamperman, A. M., Hoogendijk, W., Spicer, J., Drexhage, H. A., & Bergink, V. (2020). T-cell defects and postpartum depression. Brain, Behavior, and Immunity, 87, 397-403. https://doi.org/10.1016/j.bbi.2020.01.007

Ostrosky, P., Gómez, M., Matute, E., Rosselli, M., Ardila, A., & Pineda, D. (2002). Neuropsi Atención y Memoria. México: Manual Moderno.

Passmore, J. A., Jaspan, H. B., & Masson, L. (2016). Genital inflammation, immune activation and risk of sexual HIV acquisition. Current Opinion in HIV and AIDS, 11(2), 156-162. https://doi.org/10.1097/COH.0000000000000232

Patel, P., Borkowf, C. B., Brooks, J. T., Lasry, A., Lansky, A., & Mermin, J. (2014). Estimating per-act HIV transmission risk: a systematic review. AIDS, 28(10), 1509-1519. https://doi.org/10.1097/QAD.0000000000000298

Pattacini, L., Murnane, P. M., Kahle, E. M., Bolton, M. J., Delrow, J. J., Lingappa, J. R., Katabira, E., Donnell, D., McElrath, M. J., Baeten, J. M., & Lund, J. M. (2013). Differential regulatory T cell activity in HIV type 1-exposed seronegative individuals. AIDS Research and Human Retroviruses, 29(10), 1321-1329. https://doi.org/10.1089/AID.2013.0075

Perdue, T., Hagan, H., Thiede, H., & Valleroy, L. (2003). Depression and HIV risk behavior among Seattle-area injection drug users and young men who have sex with men. AIDS, 15(1), 81-92. https://doi.org/10.1521/aeap.15.1.81.23842

Perini, G., Cotta Ramusino, M., Sinforiani, E., Bernini, S., Petrachi, R., & Costa, A. (2019). Cognitive impairment in depression: recent advances and novel treatments. Neuropsychiatric Disease and Treatment, 15, 1249-1258. https://doi.org/10.2147/NDT.S199746

Phillips, A. C., Carroll, D., Burns, V. E., & Drayson, M. (2005). Neuroticism, cortisol reactivity, and antibody response to vaccination. Psychophysiology, 42(2), 232-238. https://doi.org/10.1111/j.1469-8986.2005.00281.x

Postal, M., Lapa, A. T., Sinicato, N. A., de Oliveira Peliçari, K., Peres, F. A., Costallat, L. T., Fernandes, P. T., Marini, R., & Appenzeller, S. (2016). Depressive symptoms are associated with tumor necrosis factor alpha in systemic lupus erythematosus. Journal of Neuroinflammation, 13, 1-7. https://doi.org/10.1186/s12974-015-0471-9

Reiche, E. M., Morimoto, H. K., & Nunes, S. M. (2005). Stress and depression-induced immune dysfunction: implications for the development and progression of cancer. International Review of Psychiatry, 17(6), 515-527. https://doi.org/10.1080/02646830500382102

Reisner, S. L., Mimiaga, M. J., Skeer, M., Bright, D., Cranston, K., Isenberg, D., Bland, S., Barker, T. A., & Mayer, K. H. (2009). Clinically significant depressive symptoms as a risk factor for HIV infection among black MSM in Massachusetts. AIDS and Behavior, 13(4), 798-810. https://doi.org/10.1007/s10461-009-9571-9

Rodkjaer, L., Chesney, M. A., Lomborg, K., Ostergaard, L., Laursen, T., & Sodemann, M. (2014). HIV-infected individuals with high coping self-efficacy are less likely to report depressive symptoms: a cross-sectional study from Denmark. International Journal of nfectious diseases: IJID: Official publication of the International Society for Infectious Diseases, 22, 67-72. https://doi.org/10.1016/j.ijid.2013.12.008

Roque, S., Correia-Neves, M., Mesquita, A. R., Palha, J. A., & Sousa, N. (2009). Interleukin-10: a key cytokine in depression? Cardiovascular Psychiatry and Neurology, 2009, 187894. https://doi.org/10.1155/2009/187894

Rothermundt, M., Arolt, V., Peters, M., Gutbrodt, H., Fenker, J., Kersting, A., & Kirchner, H. (2001). Inflammatory markers in major depression and melancholia. Journal of Affective Disorders, 63(1-3), 93-102. https://doi.org/10.1016/s0165-0327(00)00157-9

Sapsirisavat, V., Phanuphak, N., Keadpudsa, S., Egan, J. E., Pussadee, K., Klaytong, P., Reuel Friedman, M., van Griensven, F., Stall, R., & FAITH Study Team. (2016). Psychosocial and Behavioral Characteristics of High-Risk Men Who Have Sex with Men (MSM) of Unknown HIV Positive

Serostatus in Bangkok, Thailand. AIDS and behavior, 20(3), 386-397. https://doi.org/10.1007/s10461-016-1519-2

Søndergaard, S. R., Cozzi, A., Ullum, H., Wiis, J., Hermann, C. K., Laursen, S. B., Qvist, J., Gerstoft, J., Skinhøj, P., & Pedersen, B. K. (2000). Adrenaline-induced mobilization of T cells in HIV-infected patients. Clinical and Experimental Immunology, 119(1), 115-122. https://doi.org/10.1046/j.1365-2249.2000.01102.x

Sundstrom, J. B., Martinson, D. E., Mosunjac, M., Bostik, P., McMullan, L. K., Donahoe, R. M., Gravanis, M. B., & Ansari, A. A. (2003). Norepinephrine enhances adhesion of HIV-1-infected leukocytes to cardiac microvascular endothelial cells. Experimental Biology and Medicine, 228(6), 730-740. https://doi.org/10.1177/153537020322800613

Sutin, A. R., Terracciano, A., Deiana, B., Naitza, S., Ferrucci, L., Uda, M., Schlessinger, D., & Costa, P. T., Jr. (2010). High neuroticism and low conscientiousness are associated with interleukin-6. Psychological Medicine, 40(9), 1485-1493. https://doi.org/10.1017/S0033291709992029

Thilagar, S., Theyagarajan, R., Sudhakar, U., Suresh, S., Saketharaman, P., & Ahamed, N. (2018). Comparison of serum tumor necrosis factor-α levels in rheumatoid arthritis individuals with and without chronic periodontitis: A biochemical study. Journal of Indian Society of Periodontology, 22(2), 116-121. https://doi.org/10.4103/jisp.jisp_362_17

Tlhajoane, M., Eaton, J. W., Takaruza, A., Rhead, R., Maswera, R., Schur, N., Sherr, L., Nyamukapa, C., & Gregson, S. (2018). Prevalence and Associations of Psychological Distress, HIV Infection and HIV Care Service Utilization in East Zimbabwe. AIDS and Behavior, 22(5), 1485-1495. https://doi.org/10.1007/s10461-017-1705-x

Tobón, S. & Vinaccia, S. (2003). Modelo de intervención psicológica en el VIH/sida. Psicología y Salud, 13(2), 161-174. https://doi.org/10.25009/pys.v13i2.888

Trobst, K. K., Herbst, J. H., Masters, H. L., & Costa, P. T., Jr. (2002). Personality pathways to unsafe sex: Personality, condom use and HIV risk behaviors. Journal of Research in Personality, 36(2), 117-133. https://doi.org/10.1006/jrpe.2001.2334

Tucker, A., Liht, J., de Swardt, G., Jobson, G., Rebe, K., McIntyre, J., & Struthers, H. (2013). An exploration into the role of depression and self-efficacy on township men who have sex with men's ability to engage in safer sexual practices. AIDS care, 25(10), 1227-1235. https://doi.org/10.1080/09540121.2013.764383

UNAIDS. (2019). UNAIDS Data 2019. Recuperado de https://www.unaids.org/sites/default/files/media_asset/2019-UNAIDS-data_en.pdf

Vázquez Morejón, A. J., Vázquez-Morejón Jiménez, R., & Zanin, G. B. (2014). Beck Anxiety Inventory: psychometric characteristics in a sample from the clinical Spanish population. The Spanish Journal of Psychology, 17, E76. https://doi.org/10.1017/sjp.2014.76

WHO -World Health Organization. (2015). A Technical Brief. HIV And Young Men Who Have Sex With Men. Recuperado de https://www.unaids.org/sites/default/files/media_asset/2015_young_men_sex_with_men_en.pdf

Zhang, J., & Bai, C. (2017). Elevated Serum Interleukin-8 Level as a Preferable Biomarker for Identifying Uncontrolled Asthma and Glucocorticosteroid Responsiveness. Tanaffos, 16(4), 260-269. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5971756/pdf/Tanaffos-16-260.pdf

Zou, W., Feng, R., & Yang, Y. (2018). Changes in the serum levels of inflammatory cytokines in antidepressant drug-naïve patients with major depression. PloS one, 13(6), e0197267. https://doi.org/10.1371/journal.pone.0197267

Detalles del artículo

Biografía del autor/a

Jorge Emiro Restrepo, Tecnológico de Antioquia Institución Universitaria

Doctor en Neuropsicología

Wildeman Zapata, Universidad Cooperativa de Colombia

Doctor en Biología

Ana Claudia Ossa Giraldo, Universidad Cooperativa de Colombia

Doctora en Ciencias Básicas Biomédicas

Gina Paula Cuartas Montoya, Universidad Cooperativa de Colombia

Doctora en Psicología