Changes health-related quality of life in HIV-infected patients following initiation of antiretroviral therapy: a longitudinal study

Braz J Infect Dis. 2019 Jul-Aug;23(4):211-217. doi: 10.1016/j.bjid.2019.06.005. Epub 2019 Jul 22.

Abstract

Background: Several tools have been developed to evaluate HIV health-related quality of life (HRQoL) during and after antiretroviral therapy (ART). Few longitudinal studies evaluated the effect of ART on the quality of life of HIV patients.

Objective: To evaluate changes in HRQoL in HIV-infected individuals one year after initiating ART.

Methods: A prospective study was conducted from May 2016 to July 2018. Data on clinical and sociodemographic characteristics of 91 HIV-infected patients were collected prior to initiation of ART and one year thereafter. Demographic and clinical data were collected and the questionnaires 36-item Short Form Health Survey (SF-36) and HIV/AIDS-targeted quality of life (HAT-QoL) were administered in both periods. Asymptomatic individuals, aged ≥18 years, were included in the study. Patients who discontinued treatment were excluded. The association between predictors of physical and mental HRQoL was analyzed by multiple linear regression analysis.

Results: Patients were predominantly male (78.0%), mean age 35.3 ± 10.7 years, with no stable relationship (80.2%), and no comorbidities (73.6%). Most of the SF-36 domains improved after one year, particularly Physical Function (p = 0.0001), General Health (p = 0.0001), Social Functioning (p = 0.0001), Mental Health (p = 0.001), and Mental Component Summary (p = 0.004). HAT-QoL domains improved in the Overall Function (p = 0.0001), Life Satisfaction (p = 0.0001), Provider Trust (p = 0.001), and Sexual Function (p = 0.0001) domains. Sex (p = 0.032), age (p = 0.001), income (p = 0.007), and stable relationship (p = 0.004) were good predictors of the Physical Component Summary. Sex (p = 0.002) and stable relationship (p = 0.038) were good predictors of the Mental Component Summary. SF-36 and HAT-QoL scales presented strong correlations, except for Medication Concerns (0.15-0.37), HIV Mastery (0.18-0.38), Disclosure Worries (-0.15 to 0.07), and Provider Trust (-0.07 to 0.15).

Conclusions: ART improved HRQoL after one year of use. The HAT-QoL and SF-36 correlated well and are good tools to evaluate HRQoL in HIV-infected patients on ART.

Keywords: Antiretroviral Therapy; HIV; Health-related quality of life; Patient Reported Outcome Measures.

MeSH terms

  • Adult
  • Antiretroviral Therapy, Highly Active / methods*
  • Brazil
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / physiopathology
  • HIV Infections / psychology
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prospective Studies
  • Quality of Life*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Treatment Outcome
  • Viral Load