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Temporary antiretroviral treatment during primary HIV ‐1 infection has a positive impact on health‐related quality of life: data from the Primo‐ SHM cohort study
Author(s) -
Grijsen ML,
Koster GT,
Vonderen MGA,
van Kasteren M,
Kootstra GJ,
Steingrover R,
de Wolf F,
Prins JM,
Nieuwkerk PT
Publication year - 2012
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/j.1468-1293.2012.01020.x
Subject(s) - medicine , cart , quality of life (healthcare) , nausea , cohort , prospective cohort study , cohort study , human immunodeficiency virus (hiv) , randomized controlled trial , checklist , physical therapy , immunology , mechanical engineering , psychology , nursing , engineering , cognitive psychology
Objectives The aim of the study was to compare health‐related quality of life ( HRQL ) over 96 weeks in patients receiving no treatment or 24 or 60 weeks of combination antiretroviral therapy (cART) during primary HIV ‐1 infection ( PHI ). Methods A multicentre prospective cohort study of PHI patients, with an embedded randomized trial, was carried out. HRQL was assessed with the Medical Outcomes Study Health Survey for HIV ( MOS‐HIV ) and a symptom checklist administered at weeks 0, 8, 24, 36, 48, 60, 72, 84 and 96. Mixed linear models were used for the analysis of differences in HRQL among the three groups. Results A total of 112 patients were included in the study: 28 received no treatment, 45 received 24 weeks of cART and 39 received 60 weeks of cART. Over 96 weeks of follow‐up, the groups receiving 24 and 60 weeks of cART had better cognitive functioning than the no‐treatment group ( P = 0.005). Patients receiving 60 weeks of cART had less pain ( P = 0.004), better role functioning ( P = 0.001), better physical functioning ( P = 0.02) and a better physical health summary score ( P = 0.006) than the groups receiving no treatment or 24 weeks of cART. Mental health was better in patients receiving 24 weeks of cART than in patients in the no‐treatment group or the group receiving 60 weeks of cART ( P = 0.02). At week 8, patients in the groups receiving 24 and 60 weeks of cART reported more nausea ( P = 0.002), diarrhoea ( P < 0.001), abdominal pain ( P = 0.02), stomach pain ( P = 0.049) and dizziness ( P = 0.01) than those in the no‐treatment group. These differences had disappeared by week 24. Conclusions Temporary cART during PHI had a significant positive impact on patients’ HRQL as compared with no treatment, despite the initial, short‐term occurrence of more physical symptoms, probably related to drug toxicity.