Skip to main content

The effect of sertraline on depression and associations with persistent depression in survivors of HIV-related cryptococcal meningitis


Lofgren, Sarah; Boulware, David (2021), The effect of sertraline on depression and associations with persistent depression in survivors of HIV-related cryptococcal meningitis, Dryad, Dataset,


Background: Depression is associated with worse outcomes in persons living with HIV/AIDS and has a prevalence more than three times as high as in the general population. Despite this, there are few randomized studies of antidepressants in HIV-infected Africans.

Methods: We enrolled 460 HIV-infected Africans with cryptococcal meningitis into a randomized clinical trial of adjunctive sertraline vs placebo (2015-2017). We screened for clinical depression using the Center for Epidemiologic Studies Depression Scale (CES-D) at one and three months after meningitis diagnosis and initiation of treatment. We evaluated the relationship between sertraline and depression, as well as associations with persistent depression, at three months.

Results: At one- and three-months post meningitis diagnosis, 62% (108/174) and 44% (74/169) of all subjects had depression (CES>15), respectively. At three months, sertraline-treated subjects were non-significantly more likely to be depressed than placebo-treated subjects (64% vs 37%, p=0.09) but were significantly less likely to have severe depression (CES>26) (OR 0.335; 95%CI, 0.130-0.865). Of those with depression at one month, sertraline-treated subjects were less likely than placebo-treated subjects to be depressed at three months (p=0.05). Sertraline was the only factor we found significant in predicting persistent depression at three months among those who had depression at one month.

Conclusions: Depression is highly prevalent in HIV-infected persons who have survived cryptococcal meningitis. We found that sertraline is associated with a modest reduction in depression in those with depression at baseline and a significant reduction in severe depression.


Using DataFax

SAS was used to combine CRFs into a unified dataset

Usage notes

1=male ,       2=female
1=on ART,     2=not on ART

1=GCS < 15, 2=GCS = 15

GCS= Glascow Coma Scale

ART=Antiretroviral Therapy

CSF= Cerebral Spinal Fluid

LP= Lumbar Punctures

CESD= Center for Epidemiological Studies Depression Scale

The underscore than numbers is a time. _000 means baseline. 

CSF WBCs are <5 or 5+

Sterile14= sterile CSF culture at 14 weeks

Sterile18= sterile CSF culture at 18 weeks

CESD4 means CESD numeric score at 4 weeks post diagnosis with Cryptococcal Meningitis

CESD12 is CESD score at 12 weeks

vnum= visit number




National Institute of Neurological Disorders and Stroke, Award: R01 NS086312

Wellcome Trust, Award: M007413/1