Bipolar disorder in people living with HIV

1 November 2024. Related: Coinfections and complications.

Simon Collins, HIV i-Base

Two large linked population-based case control studies from Denmark report significantly higher rates of bipolar disorder among people living with HIV.

The study included 5,322 people living with HIV and 53,220 comparison controls. Median (IQR) age was 40 years (32 to 49), 85% were male and year of inclusion was 2001 (1995 to 2009).

The study included 23/5,322 (0.4%) people who were diagnosed as bipolar before the study compared to 116 (0.2%) in the control cohort, reporting almost twice the rate of HIV infection (aOR: 1.9; 95%CI: 1.2 to 3.0) especially when HIV was linked to injection drug use (aOR: 7.6; 95%CI: 2.0 to 28.9).

There was also an increased risk of bipolar disorders among people living with HIV, especially in the first two years (HR: 4.2; 95%CI: 2.4 to 7.4), although with a low 20-year incidence of only 1%.

Participants were all of Danish origin, and additional analyses reported on the use of lithium treatment and sibling health.

comment

Even with such a large and careful study, the authors recognised the complications from reverse causality and that engaging with HIV care can enable diagnoses of bipolar disorders that had not been previously recognised.

Also that late diagnosis could explain incidence after more than two years of HIV care.

Reference

Vollmond C et al. Bipolar disorder in people with HIV: A nationwide population-based matched case-control and matched cohort study. AIDS ():10.1097/QAD.0000000000004049. DOI: 10.1097/QAD.0000000000004049. (29 October 2024).
https://journals.lww.com/aidsonline/abstract/9900/bipolar_disorder_in_people_with_hiv__a_nationwide,.579.aspx