Quality of life related to health in people with HIV and associated factors
Abstract
Introduction:
in spite of there being a meaningful improvement in the survival of individuals as a consequence of antiretroviral therapy (ART), several studies have shown it affects the health-related quality of life of HIV infected people.
Objective:
to assess the health-related quality of life (HRQoL) of HIV infected people, as well as social and demographic variables, associated clinical findings, in particular in the adherence to antiretroviral therapy (ART).
Method:
transversal study of a non-probabilistic sample of HIV infected people, older than 18years old, undergoing antiretroviral therapy (ART), who were seen in the public sub-sector during a 24 month period. The MOS-HIV SF30 (HRQoL) questionnaire survey was applied. The SMAQ questionnaire was applied to assess adherence.
Results:
101 patients were included in the study. The MOS-HIV SF30 (HRQoL) questionnaire evidenced reliability and a good internal consistency. Global HRQoL score was 71.71±17.76. Global score was worse and in a few dimensions, in patients with an undetectable viral load the following was found: physical activity: p=0.016; energy/fatigue: p=0.008; perceived quality of life: p=0.025. Score for women was worse for pain: p=0.034; physical activity: p=0.006; social performance: p=0.031; mental health: p=0.040. The score was meaningfully better in a few domains among those who adhered to it (general health condition perceived p=0.027; social performance: p=0.030), in gay/bisexual boys (pain: p=0.025; daily activity: p=0.028); among those who had sex in the last month (general health condition perceived: p=0.011).
Conclusions:
the Global HRQoL score was good despite it being a population comprising multiple vulnerabilities. In spite of adherence being associated to a better perception of the HRQoL in a few domains, it had no impact on the global score. Undetectable viral load was no predictor of the HRQoL, what reinforces the idea that isolated biological parameters do not account for the complexity of perceived health condition.
References
(1) Marcus JL, Caho CR, Leyden WA, Xu L, Quesenberry CP, Klein DB, et al. Narrowing the gap in life expectancy between HIV-infected and HIV-uninfected individuals with access to care. J Acquir Immun Syndr 2016; 73(1):39-46.
(2) Gakhar H, Kamali A, Holodniy M. Health-related quality of life assessment after antiretroviral therapy: a review of the literature. Drugs 2013; 73(7):651-72.
(3) Campos LN, César CC, Guimarães MD. Quality of life among HIV-infected patients in Brazil after initiation of treatment. Clinics (Sao Paulo) 2009; 64(9):867-75.
(4) Karkashadze E, Gates MA, Chkhartishvili N, DeHovitz J, Tsertsvadze T. Assessment of quality of life in people living with HIV in Georgia. Int J STD AIDS 2017; 28(7):672-8.
(5) Lifson AR, Grandits GA, Gardner EM, Wolff MJ, Pulik P, Williams I, et al. Quality of life assessment among HIV-positive persons entering the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial. HIV Med 2015; 16(Suppl 1):88-96.
(6) Passos S Muller Klug, Souza L Dias de Mattos. Uma avaliação da qualidade de vida e seus determinantes nas pessoas vivendo com HIV/AIDS no Sul do Brasil. Cad Saúde Pública 2015; 31(4):800-14.
(7) Ventura Cerdá JM, Martín Conde MT, Morillo Verdugo R, Yébenes Cortés M, Casado Gómez MA. Adherencia, satisfacción y calidad de vida relacionada con la salud en pacientes infectados por el VIH con tratamiento antirretroviral en España: estudio ARPAS. Farm Hosp 2014; 38(4):291-9.
(8) Vigneshwaran E, Padmanabhareddy Y, Devanna N, Alvarez-Uria G. Gender differences in health related quality of life of people living with HIV/AIDS in the era of highly active antiretroviral therapy. N Am J Med Sci 2013; 5(2):102-7.
(9) Ballester-Arnal R, Gómez-Martínez S, Fumaz CR, González-García M, Remor E,Fuster MJ. A spanish study on psychological predictors of quality of life in people with HIV. AIDS Behav 2016; 20(2):281-91.
(10) Briongos Figuero LS, Bachiller Luque P, Palacios Martín T, González Sagrado M, Eiros Bouza JM. Assessment of factors influencing health-related quality of life in HIV-infected patients. HIV Med 2011; 12(1):22-30.
(11) Degroote S, Vogelaers DP, Vermeir P, Mariman A, De Rick A, Van Der Gucht B, et al. Socio-economic, behavioural, (neuro)psychological and clinical determinants of HRQoL in people living with HIV in Belgium: a pilot study. J Int AIDS Soc 2013; 16:18643.
(12) Holtz C, Sowell R, VanBrackle L, Velasquez G, Hernandez-Alonso V. A quantitative study of factors influencing quality of life in rural Mexican women diagnosed with HIV. J Assoc Nurses AIDS Care 2014; 25(6):555-67.
(13) Miners A, Phillips A, Kreif N, Rodger A, Speakman A, Fisher M, et al. Health-related quality-of-life of people with HIV in the era of combination antiretroviral treatment: a cross-sectional comparison with the general population. Lancet HIV 2014; 1(1):e32-40.
(14) Mutabazi-Mwesigire D, Katamba A, Martin F, Seeley J, Wu AW. Factors that affect quality of life among people living with HIV attending an urban clinic in Uganda: a cohort study. PLoS One 2015; 10(6):e0126810.
(15) Nobre N, Pereira M, Roine RP, Sintonen H, Sutinen J. Factors associated with the quality of life of people living with HIV in Finland. AIDS Care 2017; 29(8):1074-8.
(16) Pereira M, Canavarro MC. Gender and age differences in quality of life and the impact of psychopathological symptoms among HIV-infected patients. AIDS Behav 2011; 15(8):1857-69.
(17) Douab T, Marcellin F, Vilotitch A, Protopopescu C, Préau M, Suzan-Monti M, et al; ANRS-VESPA2 Study Group. Health-related quality of life of people living with HIV followed up in hospitals in France: comparing trends and correlates between 2003 and 2011 (ANRS-VESPA and VESPA2 national surveys). AIDS Care 2014; 26(Suppl 1):S29-40.
(18) Francolino C, Galzerano J, Mansilla M, Dapueto J, Llado M, Deque B. Evaluación del cuestionario de calidad de vida relacionada con la salud: functional assessment of HIV infection, en pacientes portadores del virus de inmunodeficiencia humana. Rev Méd Urug 2010; 26(3):129-37.
(19) Mwesigire DM, Martin F, Seeley J, Katamba A. Relationship between CD4 count and quality of life over time among HIV patients in Uganda: a cohort study. Health Qual Life Outcomes 2015; 13:144.
(20) Jaquet A, Garanet F, Balestre E, Ekouevi DK, Azani JC, Bognounou R, et al. Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso. J Int AIDS Soc 2013; 16:18867.
(21) Mûnene E, Ekman B. Does duration on antiretroviral therapy determine health-related quality of life in people living with HIV? A cross-sectional study in a regional referral hospital in Kenya. Glob Health Action 2014; 7:23554.
(22) Vo QT, Hoffman S, Nash D, El-Sadr WM, Tymejczyk OA, Gadisa T, et al. Gender differences and psychosocial factors associated with quality of life among ART initiators in Oromia, Ethiopia. AIDS Behav 2016; 20(8):1682-91.
(23) George S, Bergin C, Clarke S, Courtney G, Codd MB. Health-related quality of life and associated factors in people with HIV: an Irish cohort study. Health Qual Life Outcomes 2016; 14(1):115.
(24) Fekete EM, Williams SL, Skinta MD, Bogusch LM. Gender differences in disclosure concerns and HIV-related quality of life. AIDS Care 2016; 28(4):450-4.
(25) Bakiono F, Ouédraogo L, Sanou M, Samadoulougou S, Guiguemdé PW, Kirakoya-Samadoulougou F, et al. Quality of life in people living with HIV: a cross-sectional study in Ouagadougou, Burkina Faso. Springerplus 2014; 3:372.
(26) Aragonés-López C, Pérez-Ávila J, Smith Fawzi MC, Castro A. Quality of life of people with HIV/AIDS receiving antiretroviral therapy in Cuba: a cross-sectional study of the national population. Am J Public Health 2012; 102(5):884-92.
(27) Mrus JM, Williams PL, Tsevat J, Cohn SE, Wu AW. Gender differences in health-related quality of life in patients with HIV/AIDS. Qual Life Res 2005; 14(2):479-91.
(28) Feinberg J, Saag M, Squires K, Currier J, Ryan R, Coate B, et al. Health-related quality of life in the gender, race, and clinical experience trial. AIDS Res Treat 2011; 2011:349165.
(29) Pérez IR, Olry de Labry Lima A, del Castillo LS, Bano JR, Ruz MA, del Arco Jimenez A. No differences in quality of life between men and women undergoing HIV antiretroviral treatment: impact of demographic, clinical and psychosocial factors. AIDS Care 2009; 21(8):943-52.
(30) da Cunha GH, Fiuza ML, Gir E, Aquino Pde S, Pinheiro AK, Galvão MT. Quality of life of men with AIDS and the model of social determinants of health. Rev Lat Am Enfermagem 2015; 23(2):183-91.
(31) Liping M, Peng X, Haijiang L, Lahong J, Fan L. Quality of life of people living with HIV/AIDS: a cross-sectional study in Zhejiang Province, China. PLoS One 2015; 10(8):e0135705.
(32) Mannheimer SB, Matts J, Telzak E, Chesney M, Child C, Wu AW, et al. Quality of life in HIV-infected individuals receiving antiretroviral therapy is related to adherence. AIDS Care 2005; 17(1):10-22.
(33) Nglazi MD, West SJ, Dave JA, Levitt NS, Lambert EV. Quality of life in individuals living with HIV/AIDS attending a public sector antiretroviral service in Cape Town, South Africa. BMC Public Health 2014; 14:676.
(34) e Silva AC, Reis RK, Nogueira JA, Gir E. Quality of life, clinical characteristics and treatment adherence of people living with HIV/AIDS. Rev Lat Am Enfermagem 2014; 22(6):994-1000.
(35) Krause DD, Butler KR, May WL. Associations between factors affecting access to care and health-related quality of life: results of a statewide HIV/AIDS cross-sectional study. AIDS Care 2013; 25(1):77-84.
(36) Jin Y, Liu Z, Wang X, Liu H, Ding G, Su Y, et al. A systematic review of cohort studies of the quality of life in HIV/AIDS patients after antiretroviral therapy. Int J STD AIDS 2014; 25(11):771-7.
(37) Zubaran C, Medeiros G, Foresti K, May W, Michelim L, Madi JM, et al. Quality of life and adherence to antiretroviral therapy in Southern Brazil. AIDS Care 2014; 26(5):619-25.
(38) Badía X, Podzamczer D, López-Lavid C, García M. Evidence-based medicine and the validation of quality-of-life questionnaires: the Spanish version of the MOS-HIV questionnaire for the evaluation of the quality of life in patients infected by HIV. Enferm Infecc Microbiol Clin 1999; 17(Suppl 2):103-13.
(39) Remor E. Fiabilidad y validez de la versión española del cuestionario MOS-SF-30 para evaluar la calidad de vida de personas infectadas por el VIH. Aten Primaria 2003; 32(1):1-10.
(40) Knobel H, Alonso J, Casado JL, Collazos J, González J, Ruiz I, et al. Validation of a simplified medication adherence questionnaire in a large cohort of HIV-infected patients: the GEEMA Study. AIDS 2002; 16(4):605-13.
(41) Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976) 2000; 25(24):3186-91.
(42) Morales Vallejo P. Estadística aplicada a las Ciencias Sociales. Tamaño necesario de la muestra: ¿cuántos sujetos necesitamos? Madrid: Universidad Pontificia Comillas, 2012. Disponible en: http://www.upcomillas.es/personal/peter/investigacion/Tama%F1oMuestra.pdf. Consulta:4/10/17.
(43) Luján Tangarife JA, Cardona Arias JA. Construcción y validación de escalas de medición en salud: revisión de propiedades psicométricas. Arch Med 2015; 11(3):1-10.
(44) Uruguay. Ministerio de Salud Pública. Programa Prioritario ITS-VIH/SIDA. Informe nacional sobre los progresos realizados en la aplicación del UNGASS. Montevideo: MSP, 2010. Disponible en: http://data.unaids.org/pub/report/2010/uruguay_2010_country_progress_report_es.pdf. Consulta: 27/4/17 .
(45) Uruguay. Ministerio de Salud Pública. Programa Nacional ITS-VIH/SIDA. Informe sobre los avances de la respuesta mundial al Sida 2014: seguimiento de la Declaración política sobre VIH/SIDA de 2011. Uruguay, informe 2014. Montevideo: MSP , 2014. Disponible en: Disponible en: http://www.msp.gub.uy/sites/default/files/Informe%20Progreso%20Global%20SIDA%202014%20Uruguay_0.pdf. Consulta: 27/4/17 .
(46) Uruguay. Junta Nacional de Drogas. 5ª Encuesta Nacional en Hogares sobre Consumo de Drogas: informe de investigación mayo 2012. Montevideo: Junta Nacional de Drogas, 2012. Disponible en: Disponible en: http://www.infodrogas.gub.uy/images/stories/pdf/v_enc_hogares_2011.pdf .Consulta: 27/4/17.
(47) Ortega Valín L, Rodríguez Lage C, Ortiz de Urbina J, Martín Sánchez V. Hacia una actualización del cuestionario SMAQ. Enferm Infecc Microbiol Clin 2010; 28(6):392-9.