HRQoL in HIV-infected children using PedsQL 4.0 and comparison with uninfected children.
OBJECTIVE
To assess the reliability and validity of Pediatric Quality of Life Inventory 4.0 (PedsQL(TM) 4.0) in children living with HIV. Also to determine the association of HIV infection, treatment regimens, and type of care received on quality of life (QoL) in pediatric patients.


METHODS
Study was conducted from January to December 2008 at Dr. Ram Manohar Lohia Hospital, New Delhi, India at the HIV pediatric outpatient department (OPD). PedsQL(TM) 4.0 was administered to 100 HIV-infected and 200 uninfected children aged 8-12 years and their primary caregivers.


RESULTS
Internal consistency reliability exceeded 0.70 for both proxy-reported and self-reported scales. Intraclass correlation coefficient demonstrated mainly larger values for parent proxy-report (interval of 0.926-0.952 with 95% confidence) than for child self-report (interval of 0.891-0.928 with 95% confidence). Factor analysis was performed and it indicated that five factors were extracted from the PedsQL(TM) 4.0 and these five factors correspond mainly to the five scales. HIV infection was associated with a negative impact on QoL among children with lower scores for physical, school, and emotional functioning and health symptoms. In contrast, uninfected children had lower social functioning scores. Our results showed antiretroviral treatment to be associated with improved QoL among HIV-infected children. We even identified infected children living at home to be at a higher distress of psychosocial functioning and health symptoms when compared with children living in care homes.


CONCLUSIONS
PedsQL(TM) is an acceptable and valid measure of health-related quality of life (HRQoL) for HIV-infected children and uninfected group. Application of this data will be helpful for program managers to devise care and support programme for both infected and uninfected children.
Banerjee
Tanushree
T
Department of Statistics, University of Delhi, A-123 Vikaspuri, New Delhi 110018, India. tanushree@aidsresearcher.org
Pensi
Tripti
T
Banerjee
Dipankar
D
D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D005163:Factor Analysis, Statistical; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology* / Q000523:psychology; D006304:Health Status; D006801:Humans; D007194:India; D008297:Male; D010290:Parents / Q000523:psychology; D010372:Pediatrics / Q000379:methods; D019727:Proxy; D011594:Psychometrics / Q000295:instrumentation; D011788:Quality of Life / Q000523:psychology; D015203:Reproducibility of Results; D012649:Self Concept; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
J Acquir Immune Defic Syndr. 2002 Aug 15;30(5):485-92
12154339
Ann Trop Paediatr. 2007 Sep;27(3):215-24
17716450
Int J STD AIDS. 2002 Oct;13(10):683-90
12396538
Qual Life Res. 2000;9(8):941-9
11284213
Am J Med. 2000 Jun 15;108(9):714-22
10924648
Med Care. 1999 Feb;37(2):126-39
10024117
JAMA. 1998 Nov 4;280(17):1497-503
9809730
J Acquir Immune Defic Syndr. 2003 Jan 1;32(1):38-47
12514412
J Behav Med. 2003 Dec;26(6):577-99
14677213
Health Qual Life Outcomes. 2003 Apr 24;1:12
12773200
Pharmacoeconomics. 2000 Jul;18(1):63-72
11010605
Pediatrics. 2005 Feb;115(2):e173-82
15629958
HIV Clin Trials. 2001 Nov-Dec;2(6):484-92
11742437
N Engl J Med. 1997 Sep 11;337(11):725-33
9287227
Med Care. 2001 Aug;39(8):800-12
11468499
Med Care. 1991 Aug;29(8):786-98
1875745
AIDS. 1993 Jul;7(7):1001-8
8357546
Pediatrics. 2006 Feb;117(2):273-83
16452344
J Acquir Immune Defic Syndr (1988). 1990;3(7):683-90
2191113
AIDS. 2000 Jan 28;14(2):181-7
10708289