title: Temporary antiretroviral treatment during primary HIV-1 infection has a positive impact on health-related quality of life: data from the Primo-SHM cohort study.
abstract: OBJECTIVE
  The aim of the study was to compare health-related quality of life (HRQL) over 96 weeks in patients receiving no treatment or 24 or 60 weeks of combination antiretroviral therapy (cART) during primary HIV-1 infection (PHI).
  
  
  METHODS
  A multicentre prospective cohort study of PHI patients, with an embedded randomized trial, was carried out. HRQL was assessed with the Medical Outcomes Study Health Survey for HIV (MOS-HIV) and a symptom checklist administered at weeks 0, 8, 24, 36, 48, 60, 72, 84 and 96. Mixed linear models were used for the analysis of differences in HRQL among the three groups.
  
  
  RESULTS
  A total of 112 patients were included in the study: 28 received no treatment, 45 received 24 weeks of cART and 39 received 60 weeks of cART. Over 96 weeks of follow-up, the groups receiving 24 and 60 weeks of cART had better cognitive functioning than the no-treatment group (P = 0.005). Patients receiving 60 weeks of cART had less pain (P = 0.004), better role functioning (P = 0.001), better physical functioning (P = 0.02) and a better physical health summary score (P = 0.006) than the groups receiving no treatment or 24 weeks of cART. Mental health was better in patients receiving 24 weeks of cART than in patients in the no-treatment group or the group receiving 60 weeks of cART (P = 0.02). At week 8, patients in the groups receiving 24 and 60 weeks of cART reported more nausea (P = 0.002), diarrhoea (P < 0.001), abdominal pain (P = 0.02), stomach pain (P = 0.049) and dizziness (P = 0.01) than those in the no-treatment group. These differences had disappeared by week 24.
  
  
  CONCLUSIONS
  Temporary cART during PHI had a significant positive impact on patients' HRQL as compared with no treatment, despite the initial, short-term occurrence of more physical symptoms, probably related to drug toxicity.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Center for Infection and Immunity, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands. m.l.grijsen@mc.uva.nl
authors.forename: Ml
authors.initials: M
authors.lastname: Grijsen
authors.forename: Gt
authors.initials: G
authors.lastname: Koster
authors.forename: Mga
authors.initials: M
authors.lastname: van Vonderen
authors.forename: M
authors.initials: M
authors.lastname: van Kasteren
authors.forename: Gj
authors.initials: G
authors.lastname: Kootstra
authors.forename: R
authors.initials: R
authors.lastname: Steingrover
authors.forename: F
authors.initials: F
authors.lastname: de Wolf
authors.forename: Jm
authors.initials: J
authors.lastname: Prins
authors.forename: Pt
authors.initials: P
authors.lastname: Nieuwkerk
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006679:HIV Seropositivity / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects*; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents