Antiretroviral therapy (ART) is inconsistently associated with depression. These associations may depend on factors such as biological sex, age, and health status. Identifying such factors may help optimize treatment of HIV and depression. We implemented a novel approach to examine interindividual variability in the association between ART agents and depressive symptoms. 3434 women living with HIV (WLWH) from the Women’s Interagency HIV Study (WIHS) were computationally divided into subgroups based on sociodemographic (e.g., age) and longitudinal (from 1995 to 2016) behavioral and clinical profiles (e.g., substance use, HIV RNA, CD4 counts). Five subgroups (n’s ranged from 482 to 802) were identified and characterized as those with: controlled HIV/vascular comorbidities; profound HIV legacy effects; younger women [<45 years of age] with hepatitis C; primarily 35–55 year olds; and poorly controlled HIV/substance use. Within each subgroup, we examined associations between ART agents used over the past 6 months and item-level depressive symptoms on the Center for Epidemiologic Studies Depression Scale. Tenofovir (4 of 5 subgroups) followed by efavirenz, emtricitabine, stavudine, lopinavir, etravirine, nelfinavir, ritonavir, and maraviroc were the most common agents associated with depressive symptoms, although the pattern and directionality varied by subgroup. For example, lopinavir was associated with fewer symptoms among the subgroup with a legacy HIV effect but more symptoms among the subgroup with well-controlled HIV/vascular comorbidities. Unexpectedly, dolutegravir and raltegravir were not associated with depressive symptoms among any subgroup. Findings underscore marked interindividual variability in ART agents on depression in WLWH. Sociodemographic, clinical, and behavioral factors are important determinants of the relationship between ART agents and depressive symptoms in WLWH.

抗逆转录病毒治疗（ART）与抑郁症的相关性不一致。这些关联可能取决于生物性别、年龄和健康状况等因素。识别这些因素可能有助于优化艾滋病毒和抑郁症的治疗。我们采用了一种新方法来检查 ART 药物与抑郁症状之间关联的个体差异。来自妇女机构间艾滋病毒研究 (WIHS) 的 3434 名艾滋病毒感染者 (WLWH) 根据社会人口统计学（例如年龄）和纵向（从 1995 年至 2016 年）行为和临床特征（例如物质使用、HIV RNA）通过计算分为亚组，CD4 计数）。五个亚组（n 范围从 482 到 802）被确定并描述为： 受控的 HIV/血管合并症；艾滋病毒遗留影响深远；患有丙型肝炎的年轻女性 [<45 岁]；主要是35-55岁；艾滋病毒/药物使用控制不力。在每个亚组中，我们检查了过去 6 个月使用的 ART 药物与流行病学研究中心抑郁量表中项目级抑郁症状之间的关联。替诺福韦（5 个亚组中的 4 个）其次是依非韦伦、恩曲他滨、司他夫定、洛匹那韦、依曲韦林、奈非那韦、利托那韦和马拉韦罗是与抑郁症状相关的最常见药物，尽管其模式和方向因亚组而异。例如，在具有艾滋病毒遗留效应的亚组中，洛匹那韦与较少的症状相关，但在艾滋病毒/血管合并症得到良好控制的亚组中，洛匹那韦的症状较多。出乎意料的是，多替拉韦和拉替拉韦在任何亚组中均与抑郁症状无关。研究结果强调了 ART 药物对 WLWH 抑郁症的显着个体差异。 社会人口学、临床和行为因素是 ART 药物与 WLWH 抑郁症状之间关系的重要决定因素。