title: Quality of life among HIV-infected patients in Brazil after initiation of treatment.
abstract: BACKGROUND
  Despite improvement in clinical treatment for HIV-infected patients, the impact of antiretroviral therapy on the overall quality of life has become a major concern.
  
  
  OBJECTIVE
  To identify factors associated with increased levels of self-reported quality of life among HIV-infected patients after four months of antiretroviral therapy.
  
  
  METHODS
  Patients were recruited at two public health referral centers for AIDS, Belo Horizonte, Brazil, for a prospective adherence study. Patients were interviewed before initiating treatment (baseline) and after one and four months. Quality of life was assessed using a psychometric instrument, and factors associated with good/very good quality of life four months after the initiation of antiretroviral therapy were assessed using a cross-sectional approach. Logistic regression was used for analysis.
  
  
  RESULTS
  Overall quality of life was classified as 'very good/good' by 66.4% of the participants four months after initiating treatment, while 33.6% classified it as 'neither poor nor good/poor/very poor'. Logistic regression indicated that >8 years of education, none/mild symptoms of anxiety and depression, no antiretroviral switch, lower number of adverse reactions and better quality of life at baseline were independently associated with good/very good quality of life over four months of treatment.
  
  
  CONCLUSIONS
  Our results highlight the importance of modifiable factors such as psychiatric symptoms and treatment-related variables that may contribute to a better quality of life among patients initiating treatment. Considering that poor quality of life is related to non-adherence to antiretroviral therapy, careful clinical monitoring of these factors may contribute to ensuring the long-term effectiveness of antiretroviral regimens.
authors.affiliation: Department of Preventive and Social Medicine, School of Medicine, Federal University of Minas Gerais, Belo Horizonte/MG, Brazil. lorenzanc@gmail.com
authors.forename: Lorenza Nogueira
authors.initials: LN
authors.lastname: Campos
authors.forename: Cibele Comini
authors.initials: CC
authors.lastname: César
authors.forename: Mark Drew Crosland
authors.initials: MD
authors.lastname: Guimarães
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology*; D001938:Brazil; D003863:Depression / Q000523:psychology*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D008297:Male; D010349:Patient Compliance / Q000523:psychology; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012959:Socioeconomic Factors
chemical_list: D019380:Anti-HIV Agents