Relationship Between Chronic Low-Grade Inflammation and Depressive Disorder in Adults Living with HIV on Antiretroviral Therapy in Borno State, North East Nigeria

Background: Adults living with HIV on antiretroviral therapy experience persistent low-grade systemic inflammation mediated by microbial translocation, immune dysregulation, and direct drug toxicity. This inflammatory milieu is hypothesised to contribute to the high prevalence of depressive disorder in this population through neuroinflammatory pathways. Empirical data from the North East zone, which carries a disproportionate burden of both HIV and mental health challenges, are absent. Objectives: This study aims to measure interleukin-6, interleukin-1 beta, tumour necrosis factor-alpha, and high-sensitivity C-reactive protein as inflammatory markers, and to assess depressive symptoms using the Patient Health Questionnaire-9, among HIV-positive adults on antiretroviral therapy at a treatment centre in Maiduguri, and to examine inflammatory mediators as predictors of depression severity. Methods: Eighty HIV-positive antiretroviral therapy recipients and forty HIV-negative controls will be recruited. Cytokines will be quantified by multiplex ELISA. CD4 count and viral load will be extracted from clinic records. Hierarchical regression modelling will examine inflammatory predictors of depression after controlling for immunological and sociodemographic variables. Expected Outcomes: Elevated interleukin-6 and tumour necrosis factor-alpha are anticipated to independently predict greater depressive symptom burden, supporting a neuroinflammatory pathway to depression in HIV-positive Nigerians. Conclusion: Findings will support integrated mental health and inflammatory monitoring within HIV treatment programmes in North East Nigeria. Keywords: HIV, inflammation, depressive disorder, antiretroviral therapy, Borno State.