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Portilla-Tamarit I, Rubio-Aparicio M, Fuster-RuizdeApodaca MJ, Portilla-Tamarit J, Reus S, Portilla J. Health-Related Quality of Life in People with Advanced HIV Disease, from 1996 to 2021: Systematic Review and Meta-analysis. AIDS Behav 2024; 28:1978-1998. [PMID: 38743382 PMCID: PMC11161547 DOI: 10.1007/s10461-024-04298-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2024] [Indexed: 05/16/2024]
Abstract
The purpose of the study was to assess the effects of advanced HIV disease (AHD) on health-related quality of life (HRQoL) in PLHIV, the changes in HRQoL outcomes over the last 25 years, and the differences between countries according to level of economic development. We conducted a systematic review and meta-analysis. The search was conducted in PubMed and Web of Science using the terms: "health-related quality of life", "HQRoL", "HIV", "AIDS", "advanced HIV disease" and "low CD4 cells". Studies inclusion criteria were: adult population; initiated after 1996 and published before July 2021; clinical trials, cross-sectional, cohort, and case-control studies; studies analyzing the relationship between AHD and HRQoL; English or Spanish language. Standardized mean differences (d+) were calculated to estimate the effect size for the meta-analyses. Summary statistics were calculated using a random-effects model, and analyses of effect moderators, using mixed-effects models. The meta-analysis included 38 studies. The results indicated that HRQoL is worse in patients with AHD compared to those without. The main HRQoL domains affected were overall health perception and concern and physical and functional health and symptoms. We found a moderate impact for age and gender on some HRQoL domains. There were no differences in relation to socioeconomic inequities, country of residence, or time period analyzed. In conclusion, advanced HIV disease has a negative impact on health and well-being in PLHIV. Our results show that despite all the advances in antiretroviral treatments over the last 25 years, AHD persists as a source of extreme vulnerability, regardless of where PLHIV live.
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Affiliation(s)
- I Portilla-Tamarit
- Department of Health Psychology, University of Alicante, Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Alicante University General Hospital, Alicante, Spain
- Spanish AIDS Research Network, Carlos III Health Institute, Madrid, Spain
| | - M Rubio-Aparicio
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain.
- Department of Basic Psychology & Methodology, Faculty of Psychology and Speech Therapy, University of Murcia, Avda. Teniente Flomesta, 5, 30003, Murcia, Spain.
| | - M J Fuster-RuizdeApodaca
- Faculty of Psychology, National Distance Learning University (UNED), Madrid, Spain
- Spanish Interdisciplinary AIDS Society (SEISIDA), 28036, Madrid, Spain
| | - J Portilla-Tamarit
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Alicante University General Hospital, Alicante, Spain
- Spanish AIDS Research Network, Carlos III Health Institute, Madrid, Spain
| | - S Reus
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Alicante University General Hospital, Alicante, Spain
- Spanish AIDS Research Network, Carlos III Health Institute, Madrid, Spain
- Department of Clinical Medicine, Miguel Hernandez University, Elche, Alicante, Spain
| | - J Portilla
- Alicante Institute for Health and Biomedical Research (ISABIAL), Alicante, Spain
- Infectious Diseases Unit, Department of Internal Medicine, Alicante University General Hospital, Alicante, Spain
- Spanish AIDS Research Network, Carlos III Health Institute, Madrid, Spain
- Department of Clinical Medicine, Miguel Hernandez University, Elche, Alicante, Spain
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Cheng Q, Bajis S, Cunningham E, Shih STF, Schulz M, Marshall AD, Martin NK, Miners A, Hajarizadeh B, Wiseman V, Dore GJ, Grebely J. Health-related quality of life among people who inject drugs in Australia. Qual Life Res 2023; 32:3195-3207. [PMID: 37351701 PMCID: PMC10522523 DOI: 10.1007/s11136-023-03465-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE There is limited research on health-related quality of life (HRQoL) among people who inject drugs (PWID). We aimed to evaluate factors associated with HRQoL among a cohort of PWID in Australia. METHODS Participants were enrolled in an observational cohort study (the LiveRLife Study) between 2014 and 2018 at 15 sites in Australia. They provided fingerstick whole-blood samples for point-of-care HCV RNA testing and underwent transient elastography to assess liver disease. Participants completed the EQ-5D-3L survey at enrolment. Regression models were used to assess the impact of clinical and socioeconomic characteristics on the EQ-5D-3L scores. RESULTS Among 751 participants (median age, 43 years; 67% male), 63% reported injection drug use in the past month, 43% had current HCV infection, and 68% had no/mild liver fibrosis (F0/F1). The mean EQ-5D-3L and EQ-VAS scores were 0.67 and 62, respectively, for the overall study population. There was no significant difference in the EQ-5D-3L scores among people with and without recent injecting drug use (mean: 0.66 vs. 0.68, median: 0.73 vs. 0.78, P = 0.405), and among people receiving and not receiving opioid agonist therapy (mean: 0.66 vs. 0.68, median: 0.73 vs. 0.76, P = 0.215). Participants who were employed were found to have the highest mean EQ-5D-3L (0.83) and EQ-VAS scores (77). The presence of current HCV infection, liver fibrosis stage, and high-risk alcohol consumption had little impact on HRQoL. CONCLUSIONS The study findings provide important HRQoL data for economic evaluations, useful for guiding the allocation of resources for HCV elimination strategies and interventions among PWID.
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Affiliation(s)
- Qinglu Cheng
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia.
| | - Sahar Bajis
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Evan Cunningham
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Sophy T F Shih
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Marcel Schulz
- St Vincent's Clinical School, UNSW Medicine, Sydney, NSW, Australia
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Sydney, NSW, Australia
| | - Alison D Marshall
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
- Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, La Jolla, CA, USA
| | - Alec Miners
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Behzad Hajarizadeh
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Virginia Wiseman
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Wallace Wurth Building, High Street, Kensington, Sydney, NSW, 2052, Australia
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Tigirigi TO, Sithole GY, Chakara P, Chirombo GZ, Chiweza AR, Mubayiwa TR, Muchemwa S, Chibanda D, Dambi JM. Evaluation of the health-related quality of life and associated factors in Zimbabwean adults living with HIV: a cross-sectional study. BMC Res Notes 2023; 16:251. [PMID: 37794503 PMCID: PMC10548739 DOI: 10.1186/s13104-023-06536-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE HIV remains a global burden, with the Sub-Saharan Africa (SSA) region reporting the largest number of people living with HIV/AIDS (PLHIV). An exponential improvement in the accessibility and uptake of antiretroviral treatment across SSA has significantly improved outcomes for PLHIV. Hence, HIV care goals have shifted from reducing mortality and morbidity to improving health-related quality of life (HRQoL). This study uses generic and condition-specific HRQoL outcomes to holistically determine the HRQoL of Zimbabwean adult PLHIV and associated factors. HRQoL is a dynamic subject construct that warrants continuous evaluation to provide meaningful feedback to various stakeholders. We enrolled 536 adult PLHIV in Zimbabwe. Collected data were analyzed through descriptive statistics and multivariate binary logistic regression. RESULTS Our study shows a high HRQoL perception by Zimbabwean PLHIV. Anxiety, depression, and poor environmental health were widely reported domains influencing HRQoL. Also, being aware of HIV status for over a year, not experiencing an adverse event, being married, having adequate finances and food security and having higher educational status were associated with higher HRQoL. It is essential to integrate mental health care into routine HIV care to improve treatment outcomes and HRQoL. Last, implementing bespoke multisectoral HRQoL-enhancement interventions is paramount.
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Affiliation(s)
- Tendai Orial Tigirigi
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe
| | - Grace Yolanda Sithole
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe
| | - Princess Chakara
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe
| | - Gracious Z Chirombo
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe
| | - Annamore Rutendo Chiweza
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe
| | - Trish R Mubayiwa
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe
| | - Sidney Muchemwa
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe.
| | - Dixon Chibanda
- Mental Health Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO Box A178, Avondale, Harare, Zimbabwe
| | - Jermaine M Dambi
- Rehabilitation Sciences Unit - Faculty of Medicine and Health Sciences, University of Zimbabwe, PO BOX AV 178, Avondale, Harare, Zimbabwe
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Yoshino Y, Wakabayashi Y, Kitazawa T. Changes in health and sleep quality after anti-retroviral treatment modification in Japanese people living with HIV. J Infect Chemother 2023; 29:948-952. [PMID: 37327872 DOI: 10.1016/j.jiac.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/05/2023] [Accepted: 06/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Anti-retroviral treatment (ART) modification for treatment simplification is performed in virologically controlled people living with Human Immunodeficiency Virus (PLWH). However, studies on the impact of these stable treatment modifications on health-related quality of life (HRQoL) measured using patient-reported outcomes (PROs) in clinical practice are scarce; this was the focus of this study. METHODS PLWH who visited Teikyo University Hospital between October 2019 and March 2021, and whose ART was changed to a newly recommended single-tablet regimen for treatment simplification, were included in the study. HRQoL and sleep quality were evaluated using the Short-Form (SF) 8 and Pittsburgh Sleep Quality Index (PSQI) global score, respectively, at two time points: before and after treatment modification. Comorbidities, duration of Human Immunodeficiency Virus diagnosis, ART initiation, ART regimens, and blood test data before and after treatment were assessed. The SF-8 was used to calculate the physical component summary (PCS) and mental component summary (MCS) scores. RESULTS Forty-nine patients (all male) were included into the study. There was no change in the PCS score before and after ART modification. The MCS score significantly improved from 48.50 ± 6.56 to 50.76 ± 4.37 (p = 0.0159). Thirteen patients' ARTs were changed to dolutegravir/lamivudine. Their HRQoL and sleep quality changes were further analyzed. Their MCS and PSQI scores had improved significantly. Thirty patients' ARTs were changed to bictegravir/tenofovir alafenamide/emtricitabine; however, there were no significant changes in their HRQoL or PSQI score. CONCLUSION ART modification for treatment simplification based on PROs may improve the HRQoL of PLWH.
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Affiliation(s)
- Yusuke Yoshino
- Teikyo University School of Medicine, Department of Microbiology and Immunology, Japan; Teikyo University Hospital, Department of General Internal Medicine, Infectious Disease Group, Japan.
| | - Yoshitaka Wakabayashi
- Teikyo University Hospital, Department of General Internal Medicine, Infectious Disease Group, Japan
| | - Takatoshi Kitazawa
- Teikyo University Hospital, Department of General Internal Medicine, Infectious Disease Group, Japan
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Kharat N, Ramachandra R, Chaurasia H, Shetty S, Begum S, Joshi B. Assessment of Health-Related Quality of Life Using EQ-5D-5L Tool With Indian Tariffs Among Reproductive Age Group Women Living With HIV in India. Value Health Reg Issues 2023; 37:113-120. [PMID: 37481902 DOI: 10.1016/j.vhri.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/07/2023] [Accepted: 04/19/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE India is witnessing declining HIV prevalence because of dedicated efforts by the government. The highly active antiretroviral therapy has improved life span of people living with HIV but bearing many side effects. Women living with HIV (WLHIV) in reproductive age group have additional burden of pregnancy-related issues. This study aimed to estimate the health utility score among WLHIV in India, particularly in context of their contraceptive use, during pregnancy and postpartum period. METHODS A primary cross-sectional study was conducted among 195 WLHIV availing antiretroviral treatment services at public health facilities of Mumbai. The EQ-5D-5L interview-based questionnaire in local language and Indian value set was used to estimate health-related quality of life (QOL) reported as mean (± SD) utility and visual analog scale (VAS) scores. The relationship between utility values and VAS scores was assessed. RESULTS The WLHIV with mean age of 31.6 (6.4) years were on antiretroviral medication for nearly 7 years, and 63% had CD4+ cell count > 500 cells/mm3. Response of "11111," that is, in full health state, was reported by 66.7%. The mean utility and VAS scores were 0.976 (± 0.0519) and 82.21 (± 15.77). Reduced health-related QOL scores were associated with pain and discomfort dimension. Utility scores among contraceptive users (0.986 [± 0.029]) was higher than nonusers (0.976 [± 0.028]). Currently pregnant WLHIV had least utility score (0.959 [± 0.088]). CONCLUSIONS WLHIV had better QOL while using contraceptives more so when they were sterilized. Pregnancy reduces the QOL. This emphasizes the need to promote effective contraceptive methods among WLHIV and prevent unintended pregnancies.
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Affiliation(s)
- Namrata Kharat
- HTA Regional Resource Hub, Department of Operational and Implementation Research, Indian Council of Medical Research - National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Revathy Ramachandra
- HTA Regional Resource Hub, Department of Operational and Implementation Research, Indian Council of Medical Research - National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Himanshu Chaurasia
- HTA Regional Resource Hub, Department of Operational and Implementation Research, Indian Council of Medical Research - National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Siddesh Shetty
- HTA Regional Resource Hub, Department of Operational and Implementation Research, Indian Council of Medical Research - National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Shahina Begum
- Department of Biostatistics, Indian Council of Medical Research - National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India
| | - Beena Joshi
- HTA Regional Resource Hub, Department of Operational and Implementation Research, Indian Council of Medical Research - National Institute for Research in Reproductive and Child Health, Mumbai, Maharashtra, India.
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Rautenberg TA, Ng SK, George G, Moosa MYS, McCluskey SM, Gilbert RF, Pillay S, Aturinda I, Ard KL, Muyindike WR, Musinguzi N, Masette G, Pillay M, Moodley P, Brijkumar J, Gandhi RT, Johnson B, Sunpath H, Bwana MB, Marconi VC, Siedner MJ. Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa. Health Qual Life Outcomes 2023; 21:94. [PMID: 37605150 PMCID: PMC10441724 DOI: 10.1186/s12955-023-02179-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Antiretroviral treatment improves health related quality of life (HRQoL) of people with human immunodeficiency virus (PWH). However, one third initiating first-line treatment experience virological failure and the determinants of HRQoL in this key population are unknown. Our study aims to identify determinants of among PWH failing antiretroviral treatment in sub-Saharan Africa. METHODS We analysed data from a cohort of PWH having virological failure (> 1,000 copies/mL) on first-line ART in South Africa and Uganda. We measured HRQoL using the EuroQOL EQ-5D-3L and used a two-part regression model to obtain by-country analyses for South Africa and Uganda. The first part identifies risk factors that were associated with the likelihood of participants reporting perfect health (utility = 1) versus non-perfect health (utility < 1). The second part identifies risk factors that were associated with the EQ-5 L-3L utility scores for participants reporting non-perfect health. We performed sensitivity analyses to compare the results between the two-part model using tobit models and ordinary least squares regression. RESULTS In both countries, males were more likely to report perfect health and participants with at least one comorbidity were less likely to report perfect health. In South Africa, participants with side effects and in Uganda those with opportunistic infections were also less likely to report perfect health. In Uganda, participants with 100% ART adherence were more likely to report perfect health. In South Africa, high HIV viral load, experiencing ART side effects, and the presence of opportunistic infections were each associated with lower HRQoL, whereas participants with 100% ART adherence reported higher HRQoL. In Uganda participants with lower CD4 count had lower HRQoL. CONCLUSION Markers of advanced disease (opportunistic infection, high viral load, low CD4), side effects, comorbidities and lack of ART adherence negatively impacted HRQoL for PWH experiencing virological failure. TRIAL REGISTRATION ClinicalTrials.gov: NCT02787499.
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Affiliation(s)
- Tamlyn A Rautenberg
- School of Medicine and Dentistry, Centre for Applied Health Economics, Griffith University, Australia (Sir Samuel Griffith Centre N78 Room 2.34), Nathan campus, QLD, 4111, Australia.
- Menzies Health Institute Queensland, Southport, Australia.
- Metro North Hospital and Health Service Queensland, Herston, Australia.
| | - Shu Kay Ng
- School of Medicine and Dentistry, Centre for Applied Health Economics, Griffith University, Australia (Sir Samuel Griffith Centre N78 Room 2.34), Nathan campus, QLD, 4111, Australia
- Menzies Health Institute Queensland, Southport, Australia
| | - Gavin George
- Health Economics and HIV Research Division, University of KwaZulu-Natal, Durban, South Africa
- Division of Social Medicine and Global Health, Lund University, Lund, Sweden
| | | | - Suzanne M McCluskey
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Rebecca F Gilbert
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Selvan Pillay
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Isaac Aturinda
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Kevin L Ard
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Winnie R Muyindike
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Nicholas Musinguzi
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Godfrey Masette
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | | | - Pravi Moodley
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- National Health Laboratory Service, Durban, South Africa
| | - Jaysingh Brijkumar
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Rajesh T Gandhi
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Brent Johnson
- Department of Biostatistics and Computation Biology, University of Rochester, Rochester, NY, USA
| | - Henry Sunpath
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Mwebesa B Bwana
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Vincent C Marconi
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Department of Global Health, Rollins School of Public Health, Atlanta, GA, USA
| | - Mark J Siedner
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
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Bradley H, Zhu Y, Duan X, Kang H, Qu B. HIV-Specific Reported Outcome Measures: Systematic Review of Psychometric Properties. JMIR Public Health Surveill 2022; 8:e39015. [PMID: 36222289 PMCID: PMC9782451 DOI: 10.2196/39015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/03/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The management of people living with HIV and AIDS is multidimensional and complex. Using patient-reported outcome measures (PROMs) has been increasingly recognized to be the key factor for providing patient-centered health care to meet the lifelong needs of people living with HIV and AIDS from diagnosis to death. However, there is currently no consensus on a PROM recommended for health care providers and researchers to assess health outcomes in people living with HIV and AIDS. OBJECTIVE The purpose of this systematic review was to summarize and categorize the available validated HIV-specific PROMs in adults living with HIV and AIDS and to assess these PROMs using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) methodology. METHODS This systematic review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search of 3 recommended databases (PubMed, Embase, and PsychINFO) was conducted on January 15, 2021. Studies were included if they assessed any psychometric property of HIV-specific PROMs in adults living with HIV and AIDS and met the eligibility criteria. The PROMs were assessed for 9 psychometric properties, evaluated in each included study following the COSMIN methodology by assessing the following: the methodological quality assessed using the COSMIN risk of bias checklist; overall rating of results; level of evidence assessed using the modified Grading of Recommendations, Assessment, Development, and Evaluation approach; and level of recommendation. RESULTS A total of 88 PROMs classified into 8 categories, assessing the psychometric properties of PROMs for adults living with HIV and AIDS, were identified in 152 studies including 79,213 people living with HIV and AIDS. The psychometric properties of most included PROMs were rated with insufficient evidence. The PROMs that received class A recommendation were the Poz Quality of Life, HIV Symptom Index or Symptoms Distress Module of the Adult AIDS Clinical Trial Group, and People Living with HIV Resilience Scale. In addition, because of a lack of evidence, recommendations regarding use could not be made for most of the remaining assessed PROMs (received class B recommendation). CONCLUSIONS This systematic review recommends 3 PROMs to assess health outcomes in adults living with HIV and AIDS. However, all these PROMs have some shortcomings. In addition, most of the included PROMs do not have sufficient evidence for assessing their psychometric properties and require a more comprehensive validation of the psychometric properties in the future to provide more scientific evidence. Thus, our findings may provide a reference for the selection of high-quality HIV-specific PROMs by health care providers and researchers for clinical practice and research.
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Affiliation(s)
| | - Yaxin Zhu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Xiyu Duan
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Hao Kang
- Administration Department of Nosocomial Infection, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Bo Qu
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China.,School of Public Health, China Medical University, Shenyang, China
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Health-Related Quality of Life of HIV Positive Patients with Hypertension: Is There an Association with Blood Pressure Control? High Blood Press Cardiovasc Prev 2022; 29:393-400. [PMID: 35723847 PMCID: PMC9207838 DOI: 10.1007/s40292-022-00527-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/19/2022] [Indexed: 10/29/2022] Open
Abstract
INTRODUCTION The presence of comorbidities could affect the health-related quality of life (HRQoL) of people living with HIV (PLHIV). AIM To assess the HRQoL of PLHIV and Hypertension, as well as its association with blood pressure (BP) control. METHODS This cross-sectional study was conducted in the HIV clinic of the University of Uyo Teaching Hospial in Akwa Ibom State, Nigeria, between August and October 2018. The EQ-5D-5L was administered to 201 eligible outpatients in the waiting area of the clinic before consulting the physician. Patients' socio-demographic and clinical data were obtained from the medical records. Blood pressure was measured using an automatic BP monitor. Data were analyzed with SPSS version 20.0. RESULTS Majority (58.6%) of the respondents were females; mean age was 49.59 ± 8.97 years; mean systolic and diastolic BP were 152.77 ± 19.38 mmHg and 90.28 ± 11.33 mmHg, respectively. EQ-VAS and EQ-5D index scores were 80.99 ± 15.97 and 0.86 ± 0.05, respectively. There were no significant differences in EQ-VAS score (z = - 0.113, p = 0.910) or EQ-5D utility (z = - 0.523, p = 0.601) between participants with controlled and uncontrolled BP. Duration on antihypertensive drugs was associated with EQ-VAS score (χ2(2) = 6.558, p = 0.038), while employment status was associated with EQ-5D utility (z = - 2.661, p = 0.008). CONCLUSIONS PLHIV and hypertension accessing care at a Nigerian hospital reported a high HRQoL, irrespective of BP control status. Nevertheless, there is a need to provide psychological support and employment for this population to maximise their HRQoL.
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Mokgethi NO, Christofides N, Machisa M, Akpomiemie G, Lalla-Edward S. Quality of life and associated factors among people receiving second-line anti-retroviral therapy in Johannesburg, South Africa. BMC Infect Dis 2022; 22:456. [PMID: 35550020 PMCID: PMC9103409 DOI: 10.1186/s12879-022-07429-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/22/2022] [Indexed: 12/02/2022] Open
Abstract
Background Studies which examine quality of life (QOL) provide important insights that are needed to understand the impacts of HIV/AIDS anti-retroviral treatment (ART), comorbid conditions and other factors on the daily activities of people living with HIV/AIDS (PLH). This study aimed to determine the inter-relationships between clinical factors, behavioural, socio-demographic variables and QOL among PLH. Methods The secondary analysis used data collected from 293 people living with HIV/AIDS (PLH) receiving second-line ART in Johannesburg in a clinical trial which evaluated the non-inferiority of ritonavir-boosted darunavir (DRV/r 400/100 mg) compared to ritonavir-boosted lopinavir (LPV/r) over a 48 week-period. Physical functioning, cognitive and mental QOL were measured using the Aids Clinical Trial Group questionnaire. Exploratory factor analyses were used to examine the structure, the relationships between and the construct validity of QOL items. Structural equation models which tested the a priori-hypothesised inter-relationships between QOL and other variables were estimated and goodness of fit of the models to the data was assessed. Results Patients on darunavir presented with lower pill burden. Older patients and women were more likely to report lower QOL scores. Pill burden mediated the effects of age, sex and treatment regimen on physical functioning QOL and adverse effects; the effects of age, sex, treatment regimen and adverse effects on cognitive QOL; and the effects of sex on mental QOL. Conclusion QOL among PLH is associated with socio-demographic and clinical factors. Therefore, QOL could be enhanced by considering PLH characteristics, clinical factors such as regimen side-effects profile, management of comorbid conditions and mitigating risks such as potential adverse drug-to-drug interactions among patients on ART. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07429-9.
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Affiliation(s)
- Nomcebo Oratile Mokgethi
- Epidemiology and Biostatistics, WHO, Bloemfontein, Free State, South Africa. .,School of Public Health, Wits University, Johannesburg, South Africa. .,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | | | - Mercilene Machisa
- School of Public Health, Wits University, Johannesburg, South Africa.,Gender and Health Research Unit, South African Medical Research Council, Pretoria, South Africa
| | - Godspower Akpomiemie
- School of Public Health, Wits University, Johannesburg, South Africa.,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samantha Lalla-Edward
- School of Public Health, Wits University, Johannesburg, South Africa.,Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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10
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Karugaba G, Thupayagale-Tshweneagae G, Moleki MM, Mabikwa OV, Matshaba M. Determinants of health-related quality of life in young adults living with perinatally acquired HIV infection in Botswana. South Afr J HIV Med 2022; 23:1362. [PMID: 35706544 PMCID: PMC9082278 DOI: 10.4102/sajhivmed.v23i1.1362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/03/2022] [Indexed: 11/26/2022] Open
Abstract
Background Due to the successful antiretroviral therapy (ART) programme in Botswana, large numbers of perinatally HIV-infected adolescents are emerging into young adulthood. Young adulthood is a critical period of human development. However, there is lack of information on the factors affecting the health-related quality of life (HRQOL) of young adults living with perinatally acquired HIV (YALPH) in Botswana. Objectives The objective of this study was to assess the HRQOL and its determinants among YALPH who were enrolled on ART at Botswana-Baylor Children’s Clinical Centre of Excellence in Gaborone, Botswana. Method A cross-sectional study assessed the HRQOL of 509 YALPH aged 18–30 years using the WHOQOL-HIV BREF. Data about other variables of interest were abstracted from medical records. Bivariate analyses were performed using t and Chi-square tests to determine the associations between demographic and clinical variables and general HRQOL. The variables that were associated with the general HRQOL at P-value < 0.1 were included in the multivariable analysis using the logistic regression approach. Results The majority of participants had good general HRQOL (78.4%). The highest mean HRQOL score was in the Physical domain (5.4 [± 2.9]) and the lowest in the Environment domain (13.8 [± 2.7]). The factors that were significantly associated with the general HRQOL included: level of education attained (P = 0.012), employment status (P = 0.069), viral load suppression (P = 0.073) and self-reported illness (P = 0.001). Conclusion Interventions that effectively increase educational attainment, employment opportunities, ART adherence, and prevention or management of illness are needed to promote good HRQOL among YALPH in Botswana.
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Affiliation(s)
- Grace Karugaba
- Department of Health Studies, University of South Africa, Pretoria, South Africa
- Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana
| | | | - Mary M. Moleki
- Department of Health Studies, University of South Africa, Pretoria, South Africa
| | - Onkabetse V. Mabikwa
- Department of Mathematics and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Mogomotsi Matshaba
- Botswana-Baylor Children’s Clinical Centre of Excellence, Gaborone, Botswana
- Baylor College of Medicine, Houston, Texas, United States of America
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11
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Qu S, Wang A, Wang X, Yang Y, Pan X, Zhang T. Health-Related Quality of Life of HIV-Positive and HIV-Negative Pregnant Women in an Impoverished Area: Cross-sectional Study. JMIR Public Health Surveill 2022; 8:e29906. [PMID: 35380543 PMCID: PMC9019641 DOI: 10.2196/29906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 10/13/2021] [Accepted: 02/21/2022] [Indexed: 11/21/2022] Open
Abstract
Background Liangshan prefecture of Sichuan province was an impoverished mountainous area in China, where the annual number of HIV-positive pregnant women accounted for approximately 10% of China’s total population in the decades before 2020. In general, pregnant women living here are likely to be physically and mentally different from those in other places. Objective This study aims to explore the health-related quality of life (HRQoL) of pregnant women living with HIV in an impoverished area. Methods From December 2018 to January 2019, HIV-positive and HIV-negative parturients within 18 months after delivery were recruited in Liangshan Prefecture, Sichuan Province. Questionnaires were designed to collect their demographic data, while the EuroQol 5-Dimension, 3-Level questionnaire was used to measure their HRQoL when they were in the second trimester from 4 to 6 months of pregnancy, and their quantitative health scores were converted to corresponding healthy utility values by using the Chinese Utility Value Integral System (time trade-off coefficient). Results A total of 250 pregnant women (133 HIV-positive and 117 HIV-negative) were enrolled in the study. Among them, 55 (41.35%) and 75 (64.10%) of HIV-positive and HIV-negative pregnant women self-reported full health (healthy state 11111), respectively. The median health utility value of the 250 pregnant women was 0.961 (IQR –0.046 to 0.961), and those of the HIV-positive and HIV-negative pregnant women were 0.875 (0.424-0.961) and 0.961 (IQR –0.046 to 0.961), respectively. We observed a significant difference only in the dimension of anxiety or depression between the two groups (P=.002) and no significant difference in the distribution of health utility indices between the two groups in terms of maternal age, education level, occupation, annual household income, prenatal care visits, family size, and medical insurance category. Multivariate ordinal logistic regression analysis showed that age (odds ratio [OR] 0.62, P<.05) and prenatal care visit (OR 0.29, P<.01) were independent risk factors for health status. Conclusions Most pregnant women self-reported satisfactory HRQoL in this impoverished mountainous area. HIV-negative pregnant women had an edge over HIV-positive pregnant women, and there were significant differences in anxiety or depression dimensions between the two groups.
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Affiliation(s)
- Shuiling Qu
- Chinese Center for Disease Control and Prevention, Beijing, China.,National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoyan Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yehuan Yang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaoping Pan
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing, China
| | - Tong Zhang
- Capital Institute of Pediatrics, Beijing, China
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12
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James PB, Wardle J, Gyasi RM, Steel A, Adams J, Kabba JA, Bah AJ, Lahai M, Conteh EB. Health-related quality of life among Ebola survivors in Sierra Leone: the role of socio-demographic, health-related and psycho-social factors. Health Qual Life Outcomes 2022; 20:10. [PMID: 35033102 PMCID: PMC8761046 DOI: 10.1186/s12955-022-01916-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background Evidence of how social factors affect the health-related quality of life (HRQoL) of Ebola virus disease (EVD) survivors is limited. Our study explores the association between socio-demographic, health-related and psycho-social (stigma) factors and EVD survivors' health-related quality of life (HRQoL) in Sierra Leone. Methods We conducted a nationwide cross-sectional study among 358 EVD survivors between January and August 2018. We used a multistage sampling method to recruit EVD survivors, and the RAND 36-Item Health Survey item was used to assess the HRQoL. Data were analysed using descriptive statistics and multiple linear regression. Results When comparing by each dimension in relation to their respective summary scores, role limitation physical [0.00 (50.00)] and role limitation emotional [0.00 (33.33)] were the most affected physical health and mental health domains among EVD survivors respectively. EVD survivors who were older (β = − 3.90, 95% CI − 6.47 to − 1.32, p = 0.003), had no formal education (β = − 2.80, 95% CI − 5.16 to − 0.43, p = 0.021), experienced a unit increase in the number of post-Ebola symptoms (β = − 1.08, 95% CI − 1.74 to − 0.43, p < 0.001) and experienced a unit increase in enacted stigma (β = − 2.61, 95% CI − 4.02 to − 1.20, p < 0.001) were more likely to report a decreased level of physical health. EVD survivors who experienced a unit increase in the time spent in the Ebola treatment centre (β = − 0.60, 95% CI − 0.103 to − 0.18, p = 0.006) and those who experienced a unit increase in enacted Stigma were more likely to report decreased levels of mental health (β = − 1.50, 95% CI − 2.67 to − 0.33, p = 0.012). Conclusion Sociodemographic, health-related, and psycho-social factors were significantly associated with decrease levels of HRQoL. Our findings improve our understanding of the factors that might influence the HRQoL and suggest the need for EVD survivors to be provided with a comprehensive healthcare package that caters for their physical and mental health needs.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia. .,Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, 2480, Australia.,Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Razak M Gyasi
- African Population and Health Research Center (APHRC), Nairobi, Kenya
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Sydney, NSW, 2007, Australia
| | - John Alimamy Kabba
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, #76 Yanta West Road, Xi'an, 710061, China
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Faculty of Basic Medical Sciences College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.,Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Michael Lahai
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Eugene B Conteh
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
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Suri S, Yoong D, Short D, Tan DH, Naccarato M, Crane HM, Musten A, Fredericksen RJ, Lober WB, Gough K. Feasibility of implementing a same-day electronic screening tool for clinical assessment to measure patient-reported outcomes for eliciting actionable information on adherence to HIV medication and related factors in a busy Canadian urban HIV clinic. Int J STD AIDS 2021; 33:247-256. [PMID: 34293990 DOI: 10.1177/09564624211032796] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An optimal adherence to antiretroviral therapy (ART) is fundamental for suppression of HIV viral load and favourable treatment outcomes. Patient-reported outcomes (PROs) are effective tools for improving patient-provider communication and focusing providers' awareness on current health problems. The objectives of this analysis were (1) to determine the feasibility of implementing an electronic screening tool to measure PROs in a Canadian HIV clinic to obtain information on ART adherence and related factors and (2) to determine the factors related to sub-optimal adherence. METHODS This implementation research with a convenience sample of 600 people living with HIV (PLWH) was conducted in a busy, academic, urban HIV clinic in Toronto, Canada. PLWH were approached to participate in PRO assessments just prior to their in-clinic appointments, including health-related domains such as mental health, housing, nutrition, financial stress and medication adherence, and responses were summarized on a single sheet available for providers to review. Feasibility of implementing PROs was assessed by quantifying response rate, completion rate, time taken and participation rate. Medication adherence was elicited by self-report of the percentage of prescribed HIV medications taken in the last month. Unadjusted and adjusted odds ratios were estimated from logistic regression models to identify factors associated with adherence of <95%. RESULTS Of the 748 PLWH invited to participate, 692 (participation rate: 92.5%) completed the PRO assessments as standard of care in clinic. Of these, 600 consented to the use of their PRO results for research and were included in this analysis. The average response rate to the ART-related questions was 96.8% and mean completion rate was 95.5%. The median time taken to complete the assessment was 12.0 (IQR = 8.4-17.3) min, adjusted 8.7 (IQR = 7.2-10.8) min. 445 (74.9%) of participants were male, and 153 (26.2%) reported dissatisfaction with ART. 105 (19.7%) of the PLWH reported ART adherence of <95%. Multivariable logistic regression identified the following risk factors for sub-optimal adherence: dissatisfaction with ART (OR = 2.30, 95% CI 1.38-3.83), not having a family doctor or not visiting a family doctor in last year (OR = 1.69, 95% CI 1.02-2.79). CONCLUSION Collecting self-reported health information from PLWH through PROs in a busy urban clinic was feasible and can provide relevant information to healthcare providers on issues related to adherence. This has a potential to help in individualizing ambulatory care.
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Affiliation(s)
- Shivali Suri
- Division of Infectious Diseases, 10071St. Michael's Hospital, Toronto, ON, Canada
| | - Deborah Yoong
- Division of Infectious Diseases, 10071St. Michael's Hospital, Toronto, ON, Canada
| | | | - Darrell Hs Tan
- Division of Infectious Diseases, 10071St. Michael's Hospital, Toronto, ON, Canada.,MAP Centre for Urban Health Solutions, 10071St. Michael's Hospital, Toronto, ON, Canada.,Department of Medicine, University of Toronto
| | - Mark Naccarato
- Division of Infectious Diseases, 10071St. Michael's Hospital, Toronto, ON, Canada
| | | | | | | | | | - Kevin Gough
- Division of Infectious Diseases, 10071St. Michael's Hospital, Toronto, ON, Canada
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14
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Ahmed A, Saqlain M, Bashir N, Dujaili J, Hashmi F, Mazhar F, Khan A, Jabeen M, Blebil A, Awaisu A. Health-related quality of life and its predictors among adults living with HIV/AIDS and receiving antiretroviral therapy in Pakistan. Qual Life Res 2021; 30:1653-1664. [PMID: 33582967 PMCID: PMC8178128 DOI: 10.1007/s11136-021-02771-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2021] [Indexed: 01/30/2023]
Abstract
BACKGROUND Health-related quality of life (HRQoL) is considered to be the fourth 90 of UNAIDS 90-90-90 target to monitor the effects of combination antiretroviral therapy (ART). ART has significantly increased the life expectancy of people living with HIV/AIDS (PLWHA). However, the impact of chronic infection on HRQoL remains unclear, while factors influencing the HRQoL may vary from one country to another. The current study aimed to assess HRQoL and its associated factors among PLWHA receiving ART in Pakistan. METHODS A cross-sectional descriptive study was conducted among PLWHA attending an ART centre of a tertiary care hospital in Islamabad, Pakistan. HRQoL was assessed using a validated Urdu version of EuroQol 5 dimensions 3 level (EQ-5D-3L) and its Visual Analogue Scale (EQ-VAS). RESULTS Of the 602 patients included in the analyses, 59.5% (n = 358) reported no impairment in self-care, while 63.1% (n = 380) were extremely anxious/depressed. The overall mean EQ-5D utility score and visual analogue scale (EQ-VAS) score were 0.388 (SD: 0.41) and 66.20 (SD: 17.22), respectively. Multivariate linear regression analysis revealed that the factors significantly associated with HRQoL were: female gender; age > 50 years; having primary and secondary education; > 1 year since HIV diagnosis; HIV serostatus AIDS-converted; higher CD 4 T lymphocytes count; detectable viral load; and increased time to ART. CONCLUSIONS The current findings have shown that PLWHA in Pakistan adherent to ART had a good overall HRQoL, though with significantly higher depression. Some of the factors identified are amenable to institution-based interventions while mitigating depression to enhance the HRQoL of PLWHA in Pakistan. The HRQoL determined in this study could be useful for future economic evaluation studies for ART and in designing future interventions.
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Affiliation(s)
- Ali Ahmed
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor Malaysia
| | - Muhammad Saqlain
- Department of Pharmacy, Quaid I Azam University Islamabad, Islamabad, Pakistan
| | - Naila Bashir
- HIV Treatment Center, Pims, National AIDs Control Programme, Islamabad, Pakistan
| | - Juman Dujaili
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor Malaysia
| | - Furqan Hashmi
- University College of Pharmacy, University of the Punjab, Allama Iqbal Campus, Lahore, 54000 Pakistan
| | - Faizan Mazhar
- Unit of Clinical Pharmacology, Department of Biomedical and Clinical Sciences L. Sacco, “Luigi Sacco” University Hospital, Università Di Milano, 20157 Milan, Italy
| | - Amjad Khan
- Department of Pharmacy, Quaid-I-Azam university, Islamabad, Pakistan
| | | | - Ali Blebil
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, 47500 Subang Jaya, Selangor Malaysia
| | - Ahmed Awaisu
- Department of Clinical Pharmacy & Practice, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
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15
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Okere NE, Censi V, Machibya C, Costigan K, Katambi P, Martelli G, de Klerk J, Hermans S, Gomez GB, Pozniak A, de Wit TR, Naniche D. Beyond viral suppression: Quality of life among stable ART clients in a differentiated service delivery intervention in Tanzania. Qual Life Res 2021; 31:159-170. [PMID: 34052956 PMCID: PMC8800900 DOI: 10.1007/s11136-021-02889-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND With antiretroviral therapy, more people living with HIV (PLHIV) in resource-limited settings are virally suppressed and living longer. WHO recommends differentiated service delivery (DSD) as an alternative, less resource-demanding way of expanding HIV services access. Monitoring client's health-related quality of life (HRQoL) is necessary to understand patients' perceptions of treatment and services but is understudied in sub-Saharan Africa. We assessed HRQoL among ART clients in Tanzania accessing two service models. METHODS Cross-sectional survey from May-August 2019 among stable ART clients randomly sampled from clinics and clubs in the Shinyanga region providing DSD and clinic-based care. HRQoL data were collected using a validated HIV-specific instrument-Functional Assessment of HIV infection (FAHI), in addition to socio-demographic, HIV care, and service accessibility data. Descriptive analysis of HRQoL, logistic regression and a stepwise multiple linear regression were performed to examine HRQoL determinants. RESULTS 629 participants were enrolled, of which 40% accessed DSD. Similar HRQoL scores [mean (SD), p-value]; FAHI total [152.2 (22.2) vs 153.8 (20.6), p 0.687] were observed among DSD and clinic-based care participants. Accessibility factors contributed more to emotional wellbeing among DSD participants compared to the clinic-based care participants (53.4% vs 18.5%, p = < 0.001). Satisfactory (> 80% of maximum score) HRQoL scoring was associated with (OR [95% CI], p-value) being male (2.59 [1.36-4.92], p 0.004) among clinic participants and with urban residence (4.72 [1.70-13.1], p 0.001) among DSD participants. CONCLUSIONS Similar HRQoL was observed in DSD and clinic-based care. Our research highlights focus areas to identify supporting interventions, ultimately optimizing HRQoL among PLHIV.
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Affiliation(s)
- Nwanneka Ebelechukwu Okere
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
| | - Veronica Censi
- Doctors with Africa (CUAMM), Test & Treat Project Shinyanga, Shinyanga, Tanzania
| | | | - Kathleen Costigan
- Bugisi Health Centre, Catholic Diocese of Shinyanga, Shinyanga, Tanzania
| | - P Katambi
- Ngokolo Health Centre, Catholic Diocese of Shinyanga, Shinyanga, Tanzania
| | - Giulia Martelli
- Doctors with Africa (CUAMM), Test & Treat Project Shinyanga, Shinyanga, Tanzania
| | - Josien de Klerk
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Sabine Hermans
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Gabriela B Gomez
- Department of Global Health and Development London School of Health and Tropical Medicine United Kingdom, London, UK
| | - Anton Pozniak
- Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Tobias Rinke de Wit
- Department of Global Health, Amsterdam Institute for Global Health and Development, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Denise Naniche
- Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain
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16
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Anosike C, Anene-Okeke CG, Akunne MO. Assessment of Health-Related Quality of Life Among Patients Infected With HIV Receiving Care in a Nigerian Tertiary Hospital. Value Health Reg Issues 2021; 25:1-6. [PMID: 33387802 DOI: 10.1016/j.vhri.2020.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Revised: 09/02/2020] [Accepted: 10/10/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Globally, an appropriate estimate of the health-related quality of life (HRQoL) of people living with HIV/AIDS (PLWHA) is essential for the economic evaluation of antiretroviral therapy (ART) programs to ensure optimal value for money. Therefore, this article aimed to evaluate the HRQoL of PLWHA on ART and to explore its predictors. METHODS A cross-sectional study was conducted among PLWHA in an ART clinic of a Nigerian tertiary hospital. The participants were selected through a computer-based simple random sampling technique. The study instrument used for data collection was the English-language version of the European Quality of Life (EQ-5D-5L). The participants completed the questionnaire in the waiting room of the clinic, and the patients' clinical data were retrieved from their medical records. Descriptive statistics and multivariate linear regression were used for data analysis. P<.05 was considered statistically significant. RESULTS Out of the 352 participants, the majority were female (66.5%), and more than half (56.2%) had a CD4 count fewer than 500 cells/mm3. The EQ-5D index and utility score of the study population were 0.72 ± 4.18 and 73.05 ± 10.36, respectively. The significant predictors of EQ-5D index were the number of children (β = -0.215, P=.026), CD4 count (β = 0.171, P=.030), and duration on ART (β = -0.144, P=.011). CONCLUSIONS Our findings suggest that PLWHA receiving ART in Nigeria had good HRQoL. However, concerted efforts targeted at improving CD4 cell count and reducing the family burden of PLWHA would enhance their HRQoL.
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Affiliation(s)
- Chibueze Anosike
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria; Pharmacoeconomics and Mental Health Research Group, University of Nigeria, Nsukka, Enugu State, Nigeria.
| | - Chigozie G Anene-Okeke
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Maureen O Akunne
- Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Enugu State, Nigeria
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17
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Dinsa Ayeno H, Megersa Atomsa K, Melesie Taye G. Assessment of Health-Related Quality of Life and Associated Factors Among HIV/AIDS Patients on Highly Active Antiretroviral Therapy (HAART) at Ambo General Hospital, West Shewa, Ethiopia. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:467-478. [PMID: 33061658 PMCID: PMC7524170 DOI: 10.2147/hiv.s259510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 08/26/2020] [Indexed: 01/24/2023]
Abstract
Background Determining the degree of health-related quality of life (HRQoL) and associated factors in human immunodeficiency virus (HIV)-positive people is of great importance. Objective The aim of this study was to assess the HRQoL and associated factors among HIV-infected patients who were on highly active antiretroviral therapy (HAART) at Ambo General Hospital. Methods A study with a cross-sectional design was conducted on 296 HIV-infected patients who were on HAART at Ambo General Hospital from February 20 to May 20, 2019. Patients were recruited by a random sampling technique and a P-value <0.05 was set as statistically significant. Th main outcome measure was HRQoL. Results The majority of study participants were female (56.8%). More than half (53%) of the participants had low overall HRQoL. Those who were married and who earned <1500 ETB were less likely to experience low overall HRQoL than single people (AOR: 4.41, P=0.024) and those who earned more (AOR: 4.27, P=0.000), respectively. Those with current illness and who had no HIV-positive family members were more likely to experience lower overall quality of life than those with no current illness (AOR: 32.29, P=0.000) and with one HIV-positive family member (AOR: 4.03, P=0.003), respectively. Those with recent WHO clinical stage I were less likely to experience a lower overall quality of life than those with stage II (AOR: 0.07, P=0.000). Conclusion Current illness, recent WHO stage and having no HIV-positive family members were found to be strongly associated with lower quality of life in HIV-positive patients on antiretroviral therapy.
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Affiliation(s)
- Hunduma Dinsa Ayeno
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Kume Megersa Atomsa
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Getu Melesie Taye
- Department of Pharmacy, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Global Research on Quality of Life of Patients with HIV/AIDS: Is It Socio-Culturally Addressed? (GAP RESEARCH). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062127. [PMID: 32210042 PMCID: PMC7143369 DOI: 10.3390/ijerph17062127] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 01/18/2023]
Abstract
Quality of life (QOL) has been considered as an important outcome indicator in holistic care for HIV-infected people, especially as HIV/AIDS transforms from a fatal illness to a chronic condition. This study aimed to identify trends and emerging topics among research concerning the QOL of people living with HIV/AIDS (PLWHA). The analyzed data were English papers published from 1996 to 2017, searched and extracted from the Web of Science Core Collection. Collaborations between countries and the correlation between the keywords were visualized by VOSviewer while the abstracts’ content was analyzed using exploratory factor analysis and Jaccard’s’ similarity index. There has been an increase in both the number of publications and citations. The United Nations of America leads in terms of paper volume. The cross-nation collaborations are mainly regional. Despite a rather comprehensive coverage of topics relating to QOL in PLWHA, there has evidently been a lack of studies focusing on socio-cultural factors and their impacts on the QOL of those who are HIV-infected. Further studies should consider investigating the role of socio-cultural factors, especially where long-term treatment is involved. Policy-level decisions are recommended to be made based on the consideration of cultural factors, while collaborations between developed and developing nations, in particular in HIV/AIDS-ridden countries, are strongly recommended.
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Onyekonwu CL, Onyeka TC, Brenda NC, Ijoma UN, Unaogu NN, Onwuekwe IO, Ugwumba F, Nwutobo CR, Nwachukwu CV. Chronic HIV infection and health related quality of life in resource poor settings-an assessment from South East Nigeria. Afr Health Sci 2020; 20:102-113. [PMID: 33402898 PMCID: PMC7750088 DOI: 10.4314/ahs.v20i1.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Health-related quality of life reflects a patient's general subjective perception of the effect of an illness or intervention on physical, psychological and social aspects of daily life. HIV infection is a major public health problem especially in developing countries where poor health infrastructure and poverty are prevalent. This paper addresses the quality of life in patients with chronic HIV infection in South East Nigeria and addresses issues that may help improve the current situation. METHODS A cross-sectional survey was carried out at the University of Nigeria Teaching Hospital, Enugu, to assess patients with HIV receiving antiretroviral therapy (ART) using a validated structured questionnaire (WHOQoL-BREF). Ethical clearance for the study was obtained. Study period was from October - December, 2017. Data obtained was analysed. RESULTS A total of 389 HIV patients consented to the study. Over 70% were aged 18- 45 years and majority were females. Females had a higher quality of life score with respect to the domain of psychological health while males had a higher score with respect to the environmental domain. Older age and presence of co-morbidities were significantly associated with affectation of physical health while younger age was associated with affectation of psychological health domain. CONCLUSION HIV impairs the quality of life for affected individuals in South East Nigeria especially across the domains of physical and psychological health. No age group is spared. The presence of co-morbidities significantly reduces quality of life in these patients. Younger patients may require mental health services in the management of their disease.
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Affiliation(s)
- Chinwe Laura Onyekonwu
- Sub-Department of Dermatology, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Tonia Chinyelu Onyeka
- Department of Anaesthesia/Pain and palliative Care Unit, Multidisciplinary Oncology Center, College of Medicine, UNTH, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Nwatu Chidimma Brenda
- Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Uchenna Nkemdilim Ijoma
- Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | | | - Ikenna Obinwanne Onwuekwe
- Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Fred Ugwumba
- Urology Unit, Department of Surgery, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | | | - Chioma Victoria Nwachukwu
- Department of Medical Physiology, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
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Sari PI, Martawinarti RTSN, Lataima NS, Berhimpong VM. The Quality of Life of Patients with HIV/AIDS Undergoing Antiretroviral Therapy: A Systematic Review. JURNAL NERS 2019. [DOI: 10.20473/jn.v14i3.16978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction: Quality of Life (QoL) is one of the most important things for a patient with HIV/AIDS. Good QoL will improve the adherence to treatment, especially antiretroviral therapy. The purpose of this study was to explore about the quality of life of the patients with HIV/AIDS undergoing antiretroviral therapy.Methods: The data was collected through a literature review from electronic databases such as Scopus, ProQuest, Google Scholar and Springerlink journal. The keywords were "quality of life", "HIV/AIDS", "quality of life of patients with HIV/AIDS" or "quality of life and HIV/AIDS and antiretroviral therapy".Results: The researcher obtained 15 articles based on the inclusion criteria. Several research articles that were analyzed showed that the Quality of Life of HIV/AIDS patients undergoing antiretroviral therapy was not all good. This is caused by the side-effects of using antiretroviral therapy and the side-effects that were physical, psychological, social and environmental.Conclusion: The impact of the side effects of antiretroviral therapy has caused the clients with HIV/AIDS to choose other therapies such as ART replacement therapy to improve the quality of life for patients with HIV/AIDS.
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Podzamczer D, Rozas N, Domingo P, Miralles C, den Eynde EV, Romero A, Deig E, Knobel H, Pasquau J, Antela A, Clotet B, Geijo P, de Castro ER, Casado MA, Muñoz A, Casado A, For The Pro-Str Study Group. Real World Patient-reported Outcomes in HIV-infected Adults Switching to EVIPLERA®, Because of a Previous Intolerance to cART. PRO-STR Study. Curr HIV Res 2019; 16:425-435. [PMID: 30760189 PMCID: PMC6700757 DOI: 10.2174/1570162x17666190212163518] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/07/2019] [Accepted: 02/11/2019] [Indexed: 12/29/2022]
Abstract
Background: To investigate the impact of switching from stable Combined Antiretroviral Therapy (cART) to single-tablet regimen (RPV/FTC/TDF=EVIPLERA®/COMPLERA®) on patient-reported outcomes in HIV-infected adults who cannot tolerate previous cART, in a real-world setting. Methods: PRO-STR is a 48-week observational, prospective, multicenter study. Presence and magnitude of symptoms (main endpoint), health-related quality-of-life (HRQoL), adherence, satisfaction with treatment and patient preferences were assessed. Results: Three hundred patients with 48-week follow-up, who switched to EVIPLERA® (mean age: 46.6 years; male: 74.0%; 74.7% switched from a non-nucleoside reverse-transcriptase-inhibitor, 25.3% from a protease inhibitor + ritonavir) were included. There was no statistical difference in median CD4+ cell count (baseline: 678.5 cells/mm3; 48-week: 683.0 cells/mm3) neither in virological suppression (≤50 copies/mL) (baseline: 98.3%; 48-week: 95.3%). The most frequent reasons for switching were neuropsychiatric (62.3%), gastrointestinal (19.3%) and biochemical/metabolic (19.3%) events. Only 7.7% of patients permanently discontinued therapy. At 48-week, all outcomes showed an improvement compared to baseline. Overall, there was a significant decrease (p-value≤0.05) in number and magnitude of symptoms, while HRQoL, satisfaction and adherence improved significantly. Most patients prefered EVIPLERA® than previous cART. According to the type of intolerance, HRQoL was improved, but only significantly in patients with neuropsychiatric and gastrointestinal symptoms. Adherence improved significantly in patients with metabolic disturbances and satisfaction with EVIPLERA® was higher in the three groups. Conclusion: Switching to EVIPLERA® from non-nucleoside reverse-transcriptase-inhibitor or protease inhibitor-based regimens due to toxicity, improved the presence/magnitude of symptoms, HRQoL, and preference with treatment. EVIPLERA® maintained a virological response, CD4+ cell count and maintained or improved adherence.
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Affiliation(s)
- D Podzamczer
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - N Rozas
- Hospital Universitari de Bellvitge, Barcelona, Spain
| | - P Domingo
- Hospital de la Santa Creu y Sant Pau, Barcelona, Spain
| | - C Miralles
- Hospital Xeral de Vigo, Pontevedra, Spain
| | | | - A Romero
- Hospital de Especialidades de Puerto Real, Cadiz, Spain
| | - E Deig
- Hospital General de Granollers, Barcelona, Spain
| | - H Knobel
- Hospital del Mar, Barcelona, Spain
| | - J Pasquau
- Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - A Antela
- Complejo Hospitalario Universitario de Santiago, A Coruna, Spain
| | - B Clotet
- Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - P Geijo
- Hospital Virgen de la Luz, Cuenca, Spain
| | | | - M A Casado
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Muñoz
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
| | - A Casado
- Pharmacoeconomics & Outcomes Research Iberia, Madrid, Spain
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Costa JDO, Pearson SA, Acurcio FDA, Bonolo PDF, Silveira MR, Ceccato MDGB. Health-related quality of life among HIV-infected patients initiating treatment in Brazil in the single-tablet regimen era. AIDS Care 2019; 31:572-581. [PMID: 30727749 DOI: 10.1080/09540121.2019.1576841] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Health-related quality of life (HRQoL) is a multidimensional concept involving an individual's self-perception about how a disease or treatment impacts their daily life. In this study, we evaluated the HRQoL and factors associated with this outcome in 366 patients initiating combination Antiretroviral Therapy (cART) in Belo Horizonte, Brazil.We measured HRQoL using the EuroQoL-5D 3 level (EQ-5D) and the HIV instrument of the World Health Organization (WHOQOL-HIV BREF) and identified factors associated with HRQoL using multilevel linear regression. Participants had been on cART treatment a median of 65.5 days at the time the instruments were completed. The median HRQoL of patients on the single-tablet regimen containing efavirenz/ tenofovir/ lamivudine and the multi-tablet regimen containing dolutegravir and tenofovir/ lamivudine were high, with no significant difference between groups. Factors consistently associated with lower HRQoL were being single (unmarried), having a lower educational level, recent cigarette smoking, recent signs and symptoms of anxiety or depression, comorbid disease and the occurrence of adverse drug reactions. We observed high levels of HRQoL in cART-treated people and no differences between dolutegravir and efavirenz-based regimens. This study provides inputs to future economic analysis and identifies opportunities to increase the HRQoL of patients by targeting modifiable factors.
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Affiliation(s)
- Juliana de Oliveira Costa
- a Programa de Pós-Graduação em Saúde Pública - Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.,b Centre for Big Data Research in Health , University of New South Wales , Sydney , Australia
| | - Sallie Anne Pearson
- b Centre for Big Data Research in Health , University of New South Wales , Sydney , Australia
| | - Francisco de Assis Acurcio
- a Programa de Pós-Graduação em Saúde Pública - Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil.,c Departamento de Farmácia Social - Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
| | - Palmira de Fátima Bonolo
- d Departamento de Medicina Preventiva e Social - Faculdade de Medicina , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
| | - Micheline Rosa Silveira
- c Departamento de Farmácia Social - Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
| | - Maria das Graças Braga Ceccato
- c Departamento de Farmácia Social - Faculdade de Farmácia , Universidade Federal de Minas Gerais , Belo Horizonte , Brazil
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Relationship Among HIV-Related Stigma, Mental Health and Quality of life for HIV-Positive Patients in Tehran. AIDS Behav 2018; 22:3773-3782. [PMID: 29297112 DOI: 10.1007/s10461-017-2023-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
People living with HIV/AIDS (PLHA) face several challenges in terms of the medical management of their disease. Alongside this are stigma, discrimination and psychosocial issues associated with HIV infection. In this study, the relationships associated with HIV-related stigma, mental health and quality of life for HIV-positive patients were investigated. This cross-sectional study examined a sample of 450 HIV positive patients from the Infectious Diseases and Behavioral Health Clinic of Imam Khomeini Hospital in the city of Tehran, Iran. PLWHA completed Socio-Demographic Characteristics, Berger Scale Stigma (BSS), General Health Questionnaire (GHQ-28), WHO Quality of life-BREF (WHOQOL-BREF) and Philips Social Support Appraisals (SSA). Stigma was significantly correlated with psychological variables, social support, and quality of life. A prevalence of psychiatric disorders was reported by 78.8%. Findings suggested that psychosocial interventions reduce HIV related stigma, address psychological disorders and build social support to improve quality of life for people living with HIV.
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Health-related quality of life assessment among people living with HIV in Rio de Janeiro, Brazil: a cross-sectional study. Qual Life Res 2018; 28:1035-1045. [PMID: 30415417 DOI: 10.1007/s11136-018-2044-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2018] [Indexed: 12/16/2022]
Abstract
PURPOSE To assess health-related quality of life (HRQoL) and its associated factors among people living with HIV/AIDS (PLWHA) in Rio de Janeiro, Brazil. METHODS A cross-sectional study including PLWHA receiving usual HIV-care at Instituto Nacional de Infectologia Evandro Chagas (INI/Fiocruz) was conducted between 2014 and 2016 in Rio de Janeiro, Brazil. The EQ-5D-3L assessed HRQoL; PHQ-2 and ASSIST were used for screening depression and substance use, respectively. Clinical variables were obtained from the INI/Fiocruz cohort database, and structured questions evaluated intimate partner violence, sexual abstinence and relationship status. Data were analysed using multivariable Tobit regression model. RESULTS A total of 1480 PLWHA were included: 64.7% were male at birth (38.4% men who have sex with men [MSM], 24.3% heterosexual men and 2% transgender women [TGW]); median age was 43.1 years, and 95.8% were receiving antiretroviral therapy. The median EQ-5D-3L utility score was 0.801. Results showed that the following factors: MSM and women; older age; lower educational level; no engagement in a relationship; depression screening positive; polysubstance use; and, detectable viral load were independently associated with worse HRQoL. CONCLUSIONS PLWHA under care at INI/Fiocruz presented good HRQoL. Polysubstance use, depression and lower educational level were among the factors negatively associated with HRQoL. This was the first time that the EQ-5D-3L utility scores were calculated for a considerable number of PLWHA in Brazil, which is a fundamental piece of information for future cost-effectiveness analysis.
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Zarova C, Chiwaridzo M, Tadyanemhandu C, Machando D, Dambi JM. The impact of social support on the health-related quality of life of adult patients with tuberculosis in Harare, Zimbabwe: a cross-sectional survey. BMC Res Notes 2018; 11:795. [PMID: 30400994 PMCID: PMC6219075 DOI: 10.1186/s13104-018-3904-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 11/01/2018] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Tuberculosis (TB) is the second prime cause of mortality in Sub-Saharan Africa and remains a major worldwide public health problem. Unfortunately, patients with TB are at risk of poor mental health. However, patients who receive an adequate amount of social support are likely to have improved health outcomes. The study was done to establish how social support influences the health-related quality of life (HRQoL) of patients with TB in Harare, Zimbabwe. Data were collected from 332 TB patients and were analysed through structural equation modelling. RESULTS The mean age of the participants was 40.1 (SD 12.5) years and most were; males (53%), married (57.8%), educated (97.3%), unemployed (40.7%), stayed with family (74.4%), and reported of less than average levels of income (51.5%). Patients received the most significant amount of social support from the family. Patients also presented with lower HRQoL as they considerably reported of pain, anxiety and depression. The final model accounted for 68.8% of the variance. Despite methodological limitations, the study findings suggest that social support optimises patients' HRQoL. Based on the patients' responses, it was noted that patients presented with lower mental health, therefore, there is a need to develop and implement patient wellness interventions.
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Affiliation(s)
- Calvin Zarova
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe
| | - Matthew Chiwaridzo
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe.,School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7700, South Africa
| | - Catherine Tadyanemhandu
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe.,Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Debra Machando
- Department of Psychiatry, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe.,Department of Psychology, University of Cape Town, Rondebosch, Cape Town, 7701, South Africa
| | - Jermaine M Dambi
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe. .,School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7700, South Africa.
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Etenyi JO, Okalebo FA, Oluka M, Sinei KA, Osanjo GO, Kurdi A, Meyer JC, Godman B, Opanga S. Comparison of Zidovudine and Tenofovir Based Regimens With Regard to Health-Related Quality of Life and Prevalence of Symptoms in HIV Patients in a Kenyan Referral Hospital. Front Pharmacol 2018; 9:984. [PMID: 30369877 PMCID: PMC6194154 DOI: 10.3389/fphar.2018.00984] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 08/10/2018] [Indexed: 11/14/2022] Open
Abstract
Aim: Zidovudine and tenofovir form the backbone of antiretroviral therapy in Kenya. However, their side-effects may affect the quality of life (QoL) of patients. The aim was to compare the health-related quality of life (HRQoL) of adult patients on tenofovir versus zidovudine based regimens in a referral hospital in Kenya to provide future guidance. Methods: A comparative cross sectional study among 501 adult out-patients on either tenofovir or zidovudine was undertaken in Kenyatta National Hospital between 2015 and 2016. The Medical Outcome Study HIV Health Survey (MOS-HIV) was administered along with other key aspects of treatment. Linear regression analysis was performed to identify determinants of HRQoL. Results: Patients on zidovudine had a higher Physical Health Summary Score (PHSS) and Mental Health Summary Score (MHSS) compared to those on tenofovir. The presence of any symptom of the disease and a stated inability to cope were negatively associated with PHSS, whilst having a regular source of income improved PHSS. Being on tenofovir, symptom of illness [β = -1.24; 95% CI (-2.253, -0.226)], absence of pain [β=0.413; 95% CI (0.152, 0.674)] and patient stated inability to cope with HIV [β = -1.029; 95% CI (-1.441, -0.617)] affected the MHSS. Patients on tenofovir and second line regimens had more signs and symptoms of illness. Conclusion: Participants on zidovudine based regimens showed a better performance across all aspects of HRQoL. These are considerations for the future.
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Affiliation(s)
- Jilian O Etenyi
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.,Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Faith A Okalebo
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.,Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Margaret Oluka
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.,Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Kipruto A Sinei
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.,Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - George O Osanjo
- Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.,Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
| | - Amanj Kurdi
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
| | - Johanna C Meyer
- Department of Public Health Pharmacy and Management, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom.,Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Solna, Sweden.,Health Economics Centre, Management School, University of Liverpool, Liverpool, United Kingdom
| | - Sylvia Opanga
- Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya
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Stevens ER, Li L, Nucifora KA, Zhou Q, McNairy ML, Gachuhi A, Lamb MR, Nuwagaba-Biribonwoha H, Sahabo R, Okello V, El-Sadr WM, Braithwaite RS. Cost-effectiveness of a combination strategy to enhance the HIV care continuum in Swaziland: Link4Health. PLoS One 2018; 13:e0204245. [PMID: 30222768 PMCID: PMC6141095 DOI: 10.1371/journal.pone.0204245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 09/04/2018] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Link4Health, a cluster-RCT, demonstrated the effectiveness of a combination strategy targeting barriers at various HIV continuum steps on linkage to and retention in care; showing effectiveness in achieving linkage to HIV care within 1 month plus retention in care at 12 months after HIV testing for people living with HIV (RR 1.48, 95% CI 1.19-1.96, p = 0.002). In addition to standard of care, Link4Health included: 1) Point-of-care CD4+ count testing; 2) Accelerated ART initiation; 3) Mobile phone appointment reminders; 4) Care and prevention package including commodities and informational materials; and 5) Non-cash financial incentive. Our objective was to evaluate the cost-effectiveness of a scale-up of the Link4Health strategy in Swaziland. METHODS AND FINDINGS We incorporated the effects and costs of the Link4Health strategy into a computer simulation of the HIV epidemic in Swaziland, comparing a scenario where the strategy was scaled up to a scenario with no implementation. The simulation combined a deterministic compartmental model of HIV transmission with a stochastic microsimulation of HIV progression calibrated to Swaziland epidemiological data. It incorporated downstream health costs potentially saved and infections potentially prevented by improved linkage and treatment adherence. We assessed the incremental cost-effectiveness ratio of Link4Health compared to standard care from a health sector perspective reported in US$2015, a time horizon of 20 years, and a discount rate of 3% in accordance with WHO guidelines.[1] Our results suggest that scale-up of the Link4Health strategy would reduce new HIV infections over 20 years by 11,059 infections, a 7% reduction from the projected 169,019 cases and prevent 5,313 deaths, an 11% reduction from the projected 49,582 deaths. Link4Health resulted in an incremental cost per infection prevented of $13,310 and an incremental cost per QALY gained of $3,560/QALY from the health sector perspective. CONCLUSIONS Using a threshold of <3 x per capita GDP, the Link4Health strategy is likely to be a cost-effective strategy for responding to the HIV epidemic in Swaziland.
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Affiliation(s)
- Elizabeth R. Stevens
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
| | - Lingfeng Li
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
| | - Kimberly A. Nucifora
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
| | - Qinlian Zhou
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
| | | | - Averie Gachuhi
- ICAP at Columbia University, New York, NY, United States of America
| | - Matthew R. Lamb
- ICAP at Columbia University, New York, NY, United States of America
| | - Harriet Nuwagaba-Biribonwoha
- ICAP at Columbia University, New York, NY, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | | | | | - Wafaa M. El-Sadr
- ICAP at Columbia University, New York, NY, United States of America
| | - R. Scott Braithwaite
- Department of Population Health, NYU School of Medicine, New York, NY, United States of America
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