Health-related quality of life in HIV-1-infected patients on HAART: a five-years longitudinal analysis accounting for dropout in the APROCO-COPILOTE cohort (ANRS CO-8).
BACKGROUND
The long-term efficacy of Highly Active Antiretroviral Therapies (HAART) has enlightened the crucial role of health-related quality of life (HRQL) among HIV-infected patients. However, any analysis of such extensive longitudinal data necessitates a suitable handling of dropout which may correlate with patients' health status.


METHODS
We analysed the HRQL evolution over 5 years for 1,000 patients initiating a protease inhibitor (PI)-containing therapy, using MOS SF-36 physical (PCS) and mental (MCS) scores. In parallel with a classical separate random effects model, we used a joint parameter-dependent selection model to account for non-ignorable dropout.


RESULTS
HRQL evolved according to a two-phase pattern, characterized by an initial improvement during the year following HAART initiation and a relative stabilization thereafter. Immunodepression and self-reported side effects were found to be negative predictors of both PCS and MCS scores. Hepatitis C virus coinfection and AIDS clinical stage were found to affect physical HRQL. Results were not significantly altered when accounting for dropout.


CONCLUSIONS
Such results, obtained on a large sample of HIV-infected patients with extensive follow-up, underline the need for a regular monitoring of patients' immunological status and for a better management of their experience with hepatitis C and HAART.
Protopopescu
Camelia
C
Health and Medical Research National Institute (INSERM), Research Unit 379, Social Sciences Applied to Medical Innovation, 23, rue Stanislas Torrents, 13006, Marseilles, France.
Marcellin
Fabienne
F
Spire
Bruno
B
Préau
Marie
M
Verdon
Renaud
R
Peyramond
Dominique
D
Raffi
François
F
Chêne
Geneviève
G
Leport
Catherine
C
Carrieri
Maria-Patrizia
MP
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D005260:Female; D005602:France; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D015497:HIV-1 / Q000187:drug effects* / Q000201:enzymology; D006304:Health Status; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010352:Patient Dropouts; D011446:Prospective Studies; D011480:Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D011788:Quality of Life; D018434:Sickness Impact Profile; D013997:Time Factors; D016896:Treatment Outcome
D011480:Protease Inhibitors