title: Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso.
abstract: BACKGROUND
  The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso.
  
  
  METHODS
  HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model.
  
  
  RESULTS
  A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 30-44] and their median CD4 count was 181 cells/mm(3) (IQR 97-269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p <10(-4)) and the mean (SD) MHS score from 42.2 (8.7) to 43.9 (3.4) (p<10(-2)). After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9) and MHS (43.8) scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p<10(-4)) and 45.3 (p<10(-3)), respectively.
  
  
  CONCLUSIONS
  The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during the follow-up of HAART-treated patients is a key component to restore HRQOL.
authors.affiliation: Université Bordeaux, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France; antoine.jaquet@isped.u-bordeaux2.fr.
authors.forename: Antoine
authors.initials: A
authors.lastname: Jaquet
authors.affiliation: Service de Médecine interne, Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU-YO), Ouagadougou, Burkina Faso.
authors.forename: Franck
authors.initials: F
authors.lastname: Garanet
authors.affiliation: Université Bordeaux, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Balestre
authors.affiliation: Université Bordeaux, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France; PACCI, Centre Hospitalier Universitaire (CHU) de Treichville, Abidjan, Cote d'Ivoire.
authors.forename: Didier K
authors.initials: DK
authors.lastname: Ekouevi
authors.affiliation: PACCI, Centre Hospitalier Universitaire (CHU) de Treichville, Abidjan, Cote d'Ivoire.
authors.forename: Jean Claude
authors.initials: JC
authors.lastname: Azani
authors.affiliation: Service de Médecine interne, Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU-YO), Ouagadougou, Burkina Faso.
authors.forename: René
authors.initials: R
authors.lastname: Bognounou
authors.affiliation: Centre médical associatif African Association Solidarity (AAS), Ouagadougou, Burkina Faso.
authors.forename: Elias
authors.initials: E
authors.lastname: Dah
authors.affiliation: Centre médical avec antenne chirurgicale de Pisssy, Ouagadougou, Burkina Faso.
authors.forename: Jean Charlemagne
authors.initials: JC
authors.lastname: Kondombo
authors.affiliation: Université Bordeaux, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France; INSERM, ISPED, Centre INSERM U897 - Epidémiologie-Biostatistique, F-33000 Bordeaux, France.
authors.forename: François
authors.initials: F
authors.lastname: Dabis
authors.affiliation: Service de Médecine interne, Centre Hospitalier Universitaire Yalgado Ouedraogo (CHU-YO), Ouagadougou, Burkina Faso.
authors.forename: Joseph
authors.initials: J
authors.lastname: Drabo
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D002050:Burkina Faso; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014505:Urban Population
chemical_list: D019380:Anti-HIV Agents
keywords: Burkina Faso; HIV/AIDS; antiretroviral treatment; quality of life; sub-Saharan Africa