title: Improvements in physical wellbeing over the first two years on antiretroviral therapy in western Kenya.
abstract: Improvements in physical wellbeing during the first six months on antiretroviral therapy (ART) are well known, but little is known regarding long-term follow-up. We conducted a prospective cohort study among 222 HIV-positive adult tea plantation workers in western Kenya to assess wellbeing over their first two years on ART. Study subjects completed a standardized questionnaire during repeat ART clinic visits. A 30-day recall period was used to elicit the number of days when subjects experienced poor health and the number of days that pain made it difficult to complete usual activities at home and work. A seven-day recall period was used to assess the severity of bodily pain, nausea, fatigue, and rash. Prevalence of most symptoms declined over time. A median of seven days poor health during the first month on ART declined to three days in the 24th month (p=0.043). For pain making usual activities difficult, a median of seven days during the first month on ART fell to zero by 12 months (p< or =0.0001) but increased to three days by two years. Any bodily pain (range 59-83%) and fatigue (range 51-84%) over the past seven days were common through two years. However, pain and fatigue often over the past seven days declined over two years (from 24-10% (p=0.067) and 41-15% (p=0.002)). Skin rash was rare at all times, though higher at two years (8.6%) than any other time. Initial improvements in physical wellbeing were sustained over two years, however, increased pain and skin rash at year two may indicate problems as treatment programs mature. These improvements in physical wellbeing will be important in sustaining the long-term success of HIV treatment programs.
authors.affiliation: Department of International Health, Center for Global Health and Development, School of Public Health, Boston University, Boston, MA, USA. mfox@bu.edu
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Fox
authors.forename: Kelly
authors.initials: K
authors.lastname: McCoy
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Larson
authors.forename: Sydney
authors.initials: S
authors.lastname: Rosen
authors.forename: Margaret
authors.initials: M
authors.lastname: Bii
authors.forename: Carolyne
authors.initials: C
authors.lastname: Sigei
authors.forename: Douglas
authors.initials: D
authors.lastname: Shaffer
authors.forename: Fred
authors.initials: F
authors.lastname: Sawe
authors.forename: Monique
authors.initials: M
authors.lastname: Wasunna
authors.forename: Jonathon L
authors.initials: JL
authors.lastname: Simon
mesh_terms: D000328:Adult; D000383:Agriculture; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D004526:Efficiency; D005076:Exanthema; D005221:Fatigue; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006304:Health Status; D006801:Humans; D007630:Kenya; D008297:Male; D008875:Middle Aged; D010146:Pain; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013662:Tea; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D013662:Tea
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