title: Symptom burden in HIV-infected adults at time of HIV diagnosis in rural Uganda.
abstract: OBJECTIVE
  This study aimed to measure symptom burden prior to antitetroviral therapy (ART) initiation in a population of adults with low CD4 presenting for human immunodeficiency virus (HIV) care and treatment in Uganda, and to explore the relationship between World Health Organization (WHO) stage, CD4 count, and symptomatology.
  
  
  METHODS
  HIV-infected, ART-naïve adults with CD4 less than 200 cells per microliter referred from voluntary testing and counseling services in rural Uganda for potential enrollment into a large double-blinded placebo-controlled trial were invited to completed the Memorial Symptom Assessment Scale-Short Form (MSAS-SF). This is a validated symptom assessment tool that records the presence and severity of 37 physical and 4 psychological symptoms.
  
  
  RESULTS
  Two hundred twelve subjects were enrolled. The mean total number of symptoms was 14.0 (standard deviation [SD] = 6). The 10 most common symptoms were pain (76%), weight loss (70%), itching (67%), feeling drowsy/tired (61%), and lack of energy (61%), numbness /tingling in hands or feet (57%), cough (53%) skin changes (52%), worry (51%), and lack of appetite (49%). The median number of symptoms was not associated with WHO stage CD4 count group.
  
  
  CONCLUSIONS
  This study demonstrates that the burden of HIV-related symptoms in individuals presenting for care in Uganda is significant and debilitating.
authors.affiliation: MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. katie.wakeham@mrcuganda.org
authors.forename: Katie
authors.initials: K
authors.lastname: Wakeham
authors.forename: Richard
authors.initials: R
authors.lastname: Harding
authors.forename: Doreen
authors.initials: D
authors.lastname: Bamukama-Namakoola
authors.forename: Jonathan
authors.initials: J
authors.lastname: Levin
authors.forename: John
authors.initials: J
authors.lastname: Kissa
authors.forename: Rosalind
authors.initials: R
authors.lastname: Parkes-Ratanshi
authors.forename: Godfrey
authors.initials: G
authors.lastname: Muzaaya
authors.forename: Heiner
authors.initials: H
authors.lastname: Grosskurth
authors.forename: David G
authors.initials: DG
authors.lastname: Lalloo
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D016001:Confidence Intervals; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D010166:Palliative Care; D012424:Rural Population; D012720:Severity of Illness Index; D013997:Time Factors; D014454:Uganda / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents