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226 Current HIV Research, 2013, 11, 226-230
Frequency of Depression and its Correlation with Serum Carnitine Level
in HIV/AIDS Patients
Haleh Rezaee
1
, Hossein Khalili
*,2
, Shima Hatamkhani
2
, Simin Dashti-Khavidaki
2
and
Zahra Khazaeipour
3
1
Infectious Diseases and Tropical Medicine Research Center, Department of Clinical Pharmacy, Faculty of Pharmacy,
Tabriz University of Medical Sciences, Tabriz, Iran;
2
Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran
University of Medical Sciences, Tehran, Iran;
3
Brain and Spinal Cord Injury Research Center, Imam Khomeini Hospital
Complex, Tehran University of Medical Sciences, Tehran, Iran
Abstract: There are some evidences regarding beneficial effects of carnitine in improvement of depression symptoms.
Incidence of depression is significantly higher among HIV positive individuals compared to HIV negative populations.
Also carnitine deficiency is prevalent in HIV positive individuals.
In a cross-sectional study correlation between serum carnitine level and depression severity based on the Beck Depression
Inventory questionnaire was assessed in 100 HIV/AIDS (42 males and 58 females) patients. According to the Beck
Depression Inventory definitions, 31%, 16%, and 21% of the patients experienced mild, moderate, and severe depression,
respectively.
The mean ± SD serum concentration of total carnitine in the patients was 37.96 ± 26.08 (μmol/L). Fifty-four (54%)
patients were categorized as carnitine deficient. A non-statistically significant negative correlation between patients’
depression scores and total levels of serum carnitine was found. Considering the prevalence of depression among
HIV/AIDS patients and probable role of carnitine in the pathogenesis of depressive disorders, more studies are needed to
reveal correlation between depression and the body storage of carnitine.
Keywords: Depression, carnitine, HIV/AIDS.
INTRODUCTION
Human immunodeficiency virus (HIV) infection can
affect several aspects of patients’ health including mood
disorders. These problems can affect patients’ quality of life,
physical and social functioning, and also cause chronic
fatigue [1]. Incidence of depression is significantly higher
among HIV positive individuals compared to HIV negative
populations [2]. Approximately half of HIV-infected patients
suffer from depression symptoms worldwide [3, 4].
There are some evidences regarding beneficial effects of
carnitine in improvement of depression symptoms [5-11].
Carnitine is a non-essential amino acid which regulates cell
membrane transport and metabolism of fatty acids. It is
synthesized from essential amino acids in the liver, brain,
and kidney but most of the human body carnitine
requirement is acquired from meat and dairy products. Other
natural sources of carnitine are nuts, seeds, legumes,
vegetables, and cereals. Most of the human body carnitine
content is available as free and acetyl-L-carnitine (ALC) [11-
13].
*Address correspondence to this author at the Department of Clinical
Pharmacy, Faculty of pharmacy, Tehran University of Medical Sciences,
Enghelab Ave, Postal Code: 1417614411, Tehran, P.O. Box: 14155/6451,
Iran; Tel: +98-912-2979329; Fax: +98-21-66461178;
E-mail: khalilih@tums.ac.ir
Carnitine deficiency is prevalent in HIV positive
individuals due to several reasons such as decreased
intestinal absorption, suppressed appetite, gastrointestinal
infections, dysphagia, concomitant malignancies, decreased
intake, problems in uptake and release of carnitine from
tissues, renal loss, decrease in adipose tissue mass,
antiretroviral treatment, and HIV infection by itself [14-21].
Considering frequency of depression and carnitine
deficiency in HIV positive patients and potential benefits of
carnitine in improvement of the depression symptoms in
non-HIV populations, frequency of depression in a sample of
Iranian HIV positive patients and its probable correlation
with serum carnitine levels have been evaluated in the
present study.
METHODS
This cross-sectional study was conducted in HIV Clinic
of Iranian HIV/AIDS Research Center of Imam Khomeini
Hospital, Tehran, Iran. During one year period (from July
2011 to July 2012), 100 HIV positive patients older than 18
years entered the study. During the study period, 141
patients were screened. Patients who did not sign the consent
form and had problems with interview were excluded. The
researcher attended the clinic during the study period and
after the descriptive study of patients, those who were
conscious for interview were selected. Regarding the number
of patients referred to the clinic and duration of recruitment,
finally 100 patients completed the study.
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