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Impact of Bereavement on Progression of AIDS and HIV Infection: A Review

Received March 12, 2008; revised June 20, 2008; accepted June 24, 2008. From the Dept. of Psychiatry and the Dept. of Medicine, and the Duke Health Community Care and Hospice, Duke University Medical Center and Durham Veterans Affairs Medical Center, Durham, NC, and Mount Sinai School of Medicine, New York, NY. Send correspondence and reprint requests to Harold W. Goforth, M.D., Dept. of Psychiatry and Behavioral Science, Duke University Medical Center, DUMC 3309, Durham, NC 27710. e-mail: harold.goforth{at}duke.edu
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Human immunodeficiency virus (HIV) disease is associated with bereavement and grief reactions brought about by the disease process itself and by the losses of loved ones. OBJECTIVE: The goal of this review is to assess the current literature regarding grief, HIV, and immunity. METHOD: The authors reviewed applicable articles retrieved from a MEDLINE literature search with the search terms "bereavement/HIV," "grief/HIV," and "immunity/grief/HIV." RESULTS: Data continue to emerge that suggest a profound role for bereavement in mediating HIV illness and the need to effectively deal with bereavement issues. CONCLUSIONS: Patients who experience maladaptive grief show more rapid losses of CD4 T-cells over time, even when controlling for age, health status, use of antiretrovirals, and illicit drug abuse. This immune dysfunction may be managed by a variety of psychotherapeutic techniques.

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