The role of neuroendocrine pathways, namely the hypothalamic-pituitary-adrenal axis and the sympathetic adrenomedullary system, in anxiety disorders is only partially understood. To date, studies do not agree on the relationship between immune function and psychological distress in persons with HIV and AIDS (Antoni et al., 1991; Sahs et al., 1994; Kimmerling et al., 1999; Sewell et al., 2000; Antoni, 2003; Dela-hanty et al., 2004). One challenge of such studies is that the physiologic effects of HIV must be distinguished from those attributed to anxiety. For further details regarding the interaction between HIV, psychiatric illness, and the immune system, please refer to Chapter 3.
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