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Inflammation is a notable predictor of depression, and people with HIV exhibit chronic inflammation despite antiretroviral therapy. We hypothesised that inflammatory biomarkers may mediate the association between HIV status and depressive symptoms. Participants (<jats:italic>N<\/jats:italic> = 60, 53% girls, median [interquartile range (IQR)] age 15.5 [15.0, 16.0] years, 70% living with HIV, of whom 90.5% were virally-suppressed) completed the nine-item Patient Health Questionnaire (PHQ-9). We measured choline and myo-inositol in basal ganglia, midfrontal gray matter, and peritrigonal white matter using magnetic resonance spectroscopy, and 16 inflammatory proteins in blood serum using ELISA and Luminex\u2122 multiplex immunoassays. Using structural equation mediation modelling, we calculated standardised indirect effect estimates with 95% confidence intervals. Median [IQR] total PHQ-9 score was 3 [0, 7]. HIV status was significantly associated with total PHQ-9 score (<jats:italic>B<\/jats:italic> = 3.32, <jats:italic>p<\/jats:italic> = 0.022). Participants with HIV showed a higher choline-to-creatine ratio in the basal ganglia than those without HIV (<jats:italic>\u03b2<\/jats:italic> = 0.86, <jats:italic>p<\/jats:italic><jats:sub>FDR<\/jats:sub> = 0.035). In blood serum, participants with HIV showed higher monocyte chemoattractant protein-1 (MCP-1, <jats:italic>\u03b2<\/jats:italic> = 0.59, <jats:italic>p<\/jats:italic><jats:sub>FDR<\/jats:sub> = 0.040), higher chitinase-3 like-1 (YKL-40, <jats:italic>\u03b2<\/jats:italic> = 0.73, <jats:italic>p<\/jats:italic><jats:sub>FDR<\/jats:sub> = 0.032), and lower interleukin-1beta (IL-1\u03b2, <jats:italic>\u03b2<\/jats:italic> = -0.67, <jats:italic>p<\/jats:italic><jats:sub>FDR<\/jats:sub> = 0.047) than those without HIV. There were no significant associations of any biomarkers with total PHQ-9 score. None of the indirect effects were significant, mediating &lt;13.1% of the association. Findings remained consistent when accounting for age, gender, and time between neuroimaging and PHQ-9 administration. Using a robust analytical approach in a community-based sample, we have shown that participants living with HIV reported greater depressive symptoms than those without HIV, but we did not find that neuroimaging and blood biomarkers of inflammation significantly mediated this association. Further studies with participants experiencing severe depression may help to elucidate the links between HIV, inflammation, and depression.<\/jats:p>","DOI":"10.1371\/journal.pone.0298787","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T18:27:05Z","timestamp":1708626425000},"page":"e0298787","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Multi-modal analysis of inflammation as a potential mediator of depressive symptoms in young people with HIV: The GOLD depression study"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1860-3865","authenticated-orcid":true,"given":"Arish","family":"Mudra Rakshasa-Loots","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalena","family":"Naidoo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thandi","family":"Hamana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Busiswa","family":"Fanqa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0123-0540","authenticated-orcid":true,"given":"Kaylee S.","family":"van Wyhe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filicity","family":"Lindani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre J. W.","family":"van der Kouwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Glashoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Kruger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frances","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.","family":"Cox","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesta M.","family":"Meintjes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Laughton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"issue":"3","key":"pone.0298787.ref001","doi-asserted-by":"crossref","first-page":"e92842","DOI":"10.1371\/journal.pone.0092842","article-title":"Excess burden of depression among HIV-infected persons receiving medical care in the United States: data from the medical monitoring project and the behavioral risk factor surveillance system.","volume":"9","author":"AN Do","year":"2014","journal-title":"PloS one"},{"key":"pone.0298787.ref002","author":"UNAIDS","year":"2023","journal-title":"Fact sheet\u2014Latest global and regional statistics on the status of the AIDS epidemic"},{"key":"pone.0298787.ref003","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1007\/s10461-019-02706-2","article-title":"Burden of depression in outpatient HIV-infected adults in sub-Saharan Africa; systematic review and meta-analysis","volume":"24","author":"S Lofgren","year":"2020","journal-title":"AIDS and Behavior"},{"issue":"2","key":"pone.0298787.ref004","doi-asserted-by":"crossref","DOI":"10.1136\/gpsych-2020-100247","article-title":"Rates and risk factors for suicidal ideation, suicide attempts and suicide deaths in persons with HIV: a systematic review and meta-analysis.","volume":"34","author":"M Pelton","year":"2021","journal-title":"General psychiatry."},{"issue":"1","key":"pone.0298787.ref005","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jadohealth.2020.01.010","article-title":"Mental health of adolescents in the era of antiretroviral therapy: is there a difference between HIV-infected and uninfected youth in South Africa?","volume":"67","author":"J Buckley","year":"2020","journal-title":"Journal of Adolescent Health"},{"key":"pone.0298787.ref006","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1017\/gmh.2020.18","article-title":"The prevalence of mental health problems in sub-Saharan adolescents living with HIV: a systematic review.","volume":"7","author":"AS Dessauvagie","year":"2020","journal-title":"Global Mental Health"},{"issue":"5","key":"pone.0298787.ref007","doi-asserted-by":"crossref","first-page":"20190037","DOI":"10.1515\/ijamh-2019-0037","article-title":"Which HIV-infected youth are at risk of developing depression and what treatments help? 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Bulus","year":"2023","journal-title":"R package version 0"},{"key":"pone.0298787.ref024","author":"CC Perez","year":"2019","journal-title":"Invisible women: Data bias in a world designed for men: Abrams"},{"issue":"1","key":"pone.0298787.ref025","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s41073-018-0050-6","article-title":"Beyond sex and gender difference in funding and reporting of health research","volume":"3","author":"O Hankivsky","year":"2018","journal-title":"Research integrity and peer review"},{"issue":"9","key":"pone.0298787.ref026","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1097\/QAD.0000000000001082","article-title":"HIV-associated CD4\/8 depletion in infancy is associated with neurometabolic reductions in the basal ganglia at age 5 years despite early antiretroviral therapy","volume":"30","author":"KK Mbugua","year":"2016","journal-title":"AIDS (London, England)."},{"issue":"6","key":"pone.0298787.ref027","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1111\/bpa.12197","article-title":"Imaging neuroinflammation? 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Mullick","year":"2022","journal-title":"JMIR Formative Research"},{"issue":"9","key":"pone.0298787.ref045","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.1038\/s41380-018-0259-2","article-title":"Socioeconomic status and inflammation: a meta-analysis","volume":"25","author":"KA Muscatell","year":"2020","journal-title":"Molecular psychiatry"},{"issue":"1","key":"pone.0298787.ref046","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1007\/s11481-019-09899-2","article-title":"Associations between antiretroviral drugs on depressive symptomatology in homogenous subgroups of women with HIV","volume":"16","author":"DW Williams","year":"2021","journal-title":"Journal of neuroimmune pharmacology"},{"key":"pone.0298787.ref047","first-page":"1","article-title":"Equity in HIV mental health research: a call to action","author":"A. 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