Meditation May Slow HIV Immune Effects

By Michael Smith, North American Correspondent, MedPage Today
Published: July 25, 2008
Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston.

LOS ANGELES, July 25 -- Stress-reducing meditation may slow the progression of HIV, researchers here said.

In a small, randomized controlled trial, an eight-week course of "mindfulness meditation" halted the decline in the number of CD4-positive T cells in recently diagnosed HIV patients, according to David Creswell, Ph.D., of the Cousins Center for Psychoneuroimmunology at the University of California Los Angeles and colleagues.

However, there was no observable effect on HIV viral load, possibly because the study included only 67 people, the researchers reported online in Brain, Behavior, and Immunity.

Action Points

Explain to interested patients that there is some evidence that stress can affect the immune system, which is the target of HIV infection.
Note that this preliminary study showed that an eight-week course of meditation, combined with practice at home, can slow the decline in the number of CD4 lymphocytes, which is a hallmark of HIV progression.

Although more study is needed, the results "provide a promising first indication that mindfulness meditation may have benefit as a complementary adjunct treatment for HIV-1," the researchers concluded.

The meditation technique is group-based and inexpensive, Dr. Creswell said in a statement, so that if the study is replicated it could be a low-cost way to improve treatment.

The researchers recruited 67 recently diagnosed HIV patients in the Los Angeles area and randomized them on a two-to-one basis to either the eight-week course or a one-day seminar on the same topic.

During the eight-week course, participants had weekly two-hour group sessions guided by an instructor, a day-long retreat in the seventh week, and 30 minutes of daily audio-guided practice at home.

Patients in the control arm had a one-day session outlining the same information, but the instructors did not suggest daily routines at home.

The endpoint of the study was change in CD4 cell count from baseline.

Using mixed effects linear models, the study showed a significant time versus treatment interaction both on log-transformed and raw CD4 cell counts, at P=0.02 and P=0.03, respectively.

Specifically, the treatment participants had a raw average increase of 20 CD4 cells, compared with an average decline of 185 cells for those in the one-day control session, the researchers found.

The effect of antiretroviral medication, either on or off treatment, did not affect the strength of the time versus treatment interaction, the researchers said.

To attempt to measure the clinical effect, the researchers compared the post-study rate of CD4-defined AIDS -- a CD4 count of fewer than 200 cells per cubic millimeter of plasma -- in both groups.

None of the participants had CD4-defined AIDS at baseline and none of those in the treatment group reached that state after the study.

In contrast, two of the control participants had a CD4 cell count below 200 after the study ended.

The difference in HIV RNA levels at baseline was not significant and the study was unable to detect any differences between the groups after the study, Dr. Creswell said.

Limitations of the study included its small size, a relatively high attrition rate, and absence of long-term follow up, the researchers said.

The study was supported by the National Institute of Mental Health, the Cousins Center for Psychoneuroimmunology, and the UCLA General Clinical Research Center. The researchers reported no conflicts.

Primary source: Brain, Behavior, and Immunity
Source reference:
Creswell JD, et al "Mindfulness meditation training effects on CD4+ T lymphocytes in HIV-1 infected adults: A small randomized controlled trial" Brain, Behavior, and Immunity 2008; DOI: 10.1016/j.bbi.2008.07.004.