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Quality of life assessment among HIV ‐positive persons entering the INSIGHT Strategic Timing of AntiRetroviral Treatment ( START ) trial
Author(s) -
Lifson AR,
Grandits GA,
Gardner EM,
Wolff MJ,
Pulik P,
Williams I,
Burman WJ
Publication year - 2015
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12237
Subject(s) - medicine , visual analogue scale , vitality , quality of life (healthcare) , mental health , body mass index , human immunodeficiency virus (hiv) , health related quality of life , gerontology , clinical trial , physical therapy , demography , psychiatry , immunology , disease , sociology , philosophy , theology , nursing
Objectives With HIV treatment prolonging survival and HIV infection now managed as a chronic illness, quality of life ( QOL ) is important to evaluate in persons living with HIV ( PLWH ). We assessed at study entry the QOL of antiretroviral‐naïve PLWH with CD4 counts > 500 cells/μL in the Strategic Timing of AntiRetroviral Treatment ( START ) clinical trial. Methods QOL was assessed with: (1) a visual analogue scale ( VAS ) for self‐assessment of overall current health; (2) the Short‐Form 12‐Item Version 2 Health Survey ® ( SF ‐12V2), for which responses are summarized into eight individual QOL domains plus component summary scores for physical health [the Physical Health Component Summary ( PCS )] and mental health [the Mental Health Component Summary ( MCS )]. The VAS and eight domain scores were scaled from 0 to 100. Mean QOL measures were calculated overall and by demographic, clinical and behavioural factors. Results A total of 4631 participants completed the VAS and 4119 the SF ‐12. The mean VAS score (with standard deviation) was 80.9 ± 15.7. Mean SF ‐12 domain scores were lowest for vitality (66.3 ± 26.4) and mental health (68.6 ± 21.4), and highest for physical functioning (89.3 ± 23.0) and bodily pain (88.0 ± 21.4). Using multiple linear regression, PCS scores were lower ( P < 0.001) for A sians, N orth A mericans, female participants, older participants, and those with less education, longer duration of known HIV infection, alcoholism/substance dependence and body mass index ≥ 30 kg/m 2 . MCS scores were highest ( P < 0.001) for A fricans, S outh A mericans and older participants, and lowest for female participants, current smokers and those with alcoholism/substance dependence. Conclusions In this primarily healthy population, QOL was mostly favourable, emphasizing that it is important that HIV treatments do not negatively impact QOL . Self‐assessed physical health summary scores were higher than mental health scores. Factors such as older age and geographical region had different effects on perceived physical and mental health.