Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
Bay Area Reporter - September 22, 2005
Matthew S. Bajko, m.bajko@ebar.com
"We are not looking for something where people might never need to go on antiretrovirals but we are looking for things people can do to stay healthy longer and not start antiretrovirals so soon," said Dr. Rick Hecht, an associate professor of medicine at the University of California, San Francisco and director of research at UCSF's Osher Center for Integrative Medicine. "That has been a big question for me over the almost 20 years since I first started seeing people who were HIV-positive and not sick yet. What can you do to stay well short of going on antiretrovirals? There is a lot we know but a lot we don't know."
Observational data has shown that stress and depression are both associated with more rapid loss of CD4+ T-cells. But little is known if interventions that address stress and mood are capable of slowing the loss of CD4+ T-cells. Several smaller studies have shown meditation can lead to immunologic benefits for HIV-positive people, said Hecht.
To get a better, broader picture Hecht and colleague Dr. Susan Folkman have launched the Staying Well Study, a clinical trial that will compare the impact of Mindfulness-Based Stress Reduction (MBSR), a meditation-based program that is taught in eight weekly sessions, to HIV education/support groups. MBSR has been shown to improve perceived stress and improve mood in prior trials.
In addition to assessing the impact of the intervention on CD4 T-lymphocyte cell counts and HIV RNA levels, the study aims to assess whether MBSR improves quality of life and mood in the study participants. The study will also perform detailed assessments of the intervention on stress hormones, and test specific mechanisms through which stress and mood may alter HIV-related immune function.
The researchers are looking to enroll 330 people into the study, who will be followed for one year. To be eligible, participants must not currently be on antiretrovirals or have stopped prior treatment for at least four months, have CD4 T-lymphocyte counts greater than 350 cells, and a viral load greater than 3000 copies/ml.
The meditation course meets each week for two and half hours over two months. Those in the course will then be asked to meditate at home each day for at least 30 minutes. Those people who are not enrolled in the meditation course will be placed in education/support groups led by Project Inform. After one year, those participants will be able to take the MBSR course for free.
Each group will be interviewed four times over 12 months with participants paid $25 per visit. For more information about the study or to enroll, contact Patty Moran at (415) 353-9745 or moranp@ocim.ucsf.edu, or call the study information number at (415) 353-9744.
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