title: The impact of combination antiretroviral therapy and its interruption on anxiety, stress, depression and quality of life in Thai patients.
abstract: OBJECTIVE
  Investigation on anxiety, stress, depression, and quality of life (QoL) within STACCATO, a randomised trial of two treatment strategies: CD4 guided scheduled treatment interruption (STI) compared to continuous treatment (CT).
  
  
  METHODS
  Thai patients with HIV-infection enrolled in the STACCATO trial.
  
  
  METHODS
  Anxiety, depression assessed by the questionnaires Hospital Anxiety and Depression Scale (HADS) and DASS, stress assessed by the Depression Anxiety Stress Scale (DASS), and QoL evaluated by the HIV Medical Outcome Study (MOS-HIV) questionnaires. Answers to questionnaires were evaluated at 4 time-points: baseline, 24 weeks, 48 weeks and at the end of STACCATO.
  
  
  RESULTS
  A total of 251 patients answered the HADS/DASS and 241 answered the MOS-HIV of the 379 Thai patients enrolled into STACCATO (66.2 and 63.6% respectively). At baseline 16.3% and 7.2% of patients reported anxiety and depression using HADS scale. Using the DASS scale, 35.1% reported mild to moderate and 9.6% reported severe anxiety; 8.8% reported mild to moderate and 2.0% reported severe depression; 42.6% reported mild to moderate and 4.8% reported severe stress. We showed a significant improvement of the MHS across time (p=0.001), but no difference between arms (p=0.17). The summarized physical health status score (PHS) did not change during the trial (p=0.15) nor between arm (p=0.45). There was no change of MHS or PHS in the STI arm, taking into account the number of STI cycle (p=0.30 and 0.57) but MHS significant increased across time-points (p=0.007).
  
  
  CONCLUSIONS
  Antiretroviral therapy improved mental health and QOL, irrespective of the treatment strategy.
authors.affiliation: HIV-NAT, The Thai Red Cross AIDS Research Center, Bangkok, Thailand. reto.nuesch@hirslanden.ch
authors.forename: Reto
authors.initials: R
authors.lastname: Nüesch
authors.forename: Angèle
authors.initials: A
authors.lastname: Gayet-Ageron
authors.forename: Ploenchan
authors.initials: P
authors.lastname: Chetchotisakd
authors.forename: Wisit
authors.initials: W
authors.lastname: Prasithsirikul
authors.forename: Sasisopin
authors.initials: S
authors.lastname: Kiertiburanakul
authors.forename: Warangkana
authors.initials: W
authors.lastname: Munsakul
authors.forename: Phitsanu
authors.initials: P
authors.lastname: Raksakulkarn
authors.forename: Somboon
authors.initials: S
authors.lastname: Tansuphasawasdikul
authors.forename: Sineenart
authors.initials: S
authors.lastname: Chautrakarn
authors.forename: Kiat
authors.initials: K
authors.lastname: Ruxrungtham
authors.forename: Bernard
authors.initials: B
authors.lastname: Hirschel
authors.forename: Jintanat
authors.initials: J
authors.lastname: Anaworanich