Evaluating health-related wellbeing outcomes among outpatient adults with human immunodeficiency virus infection in the HAART era.
Quality of life (QoL) changes among 56 adult patients living with HIV/AID (PHA) were assessed following two years of care in which most had received highly active antiretroviral therapy (HAART). The sample was stratified by initial disease stage; subjects were classified 'asymptomatic' if they had no HIV-related constitutional symptoms, 'symptomatic' if they had at least one symptom, and 'AIDS' if symptomatic with a history of opportunistic infections and/or CD4 count less than 200 cells/ micro L. For the overall group, changes in mean QoL (Medical Outcomes Study Short-Form-36 [SF-36]) ratings were non-significant, irrespective of initial disease stage or prior HAART exposure. Although overall there were health status improvements over the two-year period, clinical changes were generally unrelated to changes in QoL ratings. Patients with better immunologic/virologic outcomes showed slight improvements in mean QoL ratings, while those with poorer clinical outcomes showed slight deterioration. These within-group changes over time were statistically non-significant. The corresponding between-group differences in changes in SF-36 social and psychological dimensions were significant. Statistically significant differences among the three disease stage groups on a number of subscales at baseline (Physical Function, Body Pain, Vitality, Role Limitations due to Physical Problems) became non-significant (i.e. nullified) at follow-up. Significant increases in mean number of symptoms for the asymptomatic and symptomatic groups were not associated with two-year changes in QoL ratings. Overall, wellbeing was moderately stable over the two-year follow-up period, although somewhat affected by symptom changes and immunologic/virologic outcome. The study results contrast with pre-HAART longitudinal research, in which deterioration in all areas of QoL occurred.
Saunders
Douglas S
DS
Department of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada.
Burgoyne
Robert W
RW
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000523:psychology*; D018791:CD4 Lymphocyte Count; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000523:psychology*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010045:Outpatients / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D019562:Viral Load