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Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme.

Pitt J, Myer L, Wood R - J Int AIDS Soc (2009)

Bottom Line: Overall, 23% of participants experienced a decline in their physical health summary score, while 34% showed a decline in the mental health summary score.Average drops in median physical and mental health summary scores were 8.4 units (SD 9.31) and 9.9 (SD 11.4) units respectively.This was largely related to better baseline clinical state.

View Article: PubMed Central - HTML - PubMed

Affiliation: Desmond Tutu HIV Foundation, Institute of Infectious Diseases and Molecular Medicine, Cape Town, South Africa. jennifer.pitt@hiv-research.org.za.

ABSTRACT

Background: The impact of highly active antiretroviral therapy (HAART) on health-related quality of life has been widely researched in the developed world, but there are few data from sub-Saharan Africa, where the vast majority of HIV-infected individuals live. This study examined health-related quality of life among HIV-positive individuals initiating HAART in Cape Town, South Africa, and explored the impact of HAART-related drug toxicities on quality of life.

Methods: Health-related quality of life was assessed using a standardised questionnaire, the Medical Outcomes Survey Short Form 36. Physical health summary scores and mental health summary scores were compared pre-HAART and at regular intervals during the first 48 weeks of HAART. The relationships between socio-demographic, baseline and on-treatment variables and decline in health-related quality of life, as well as the impact of drug toxicities on quality of life, were assessed in unadjusted bivariate and adjusted multivariate analyses.

Results: Two hundred and ninety-five patients were enrolled into the study. There was a significant increase in health-related quality of life during the first 48 weeks on HAART. The median physical health summary score increased from 45 to 53 units (p < 0.001) and median mental health summary score increased from 45 to 50 units (p < 0.001).The bulk of this increase occurred during the first 16 weeks. Overall, 23% of participants experienced a decline in their physical health summary score, while 34% showed a decline in the mental health summary score. Average drops in median physical and mental health summary scores were 8.4 units (SD 9.31) and 9.9 (SD 11.4) units respectively. Participants with drug toxicity had lower physical health summary scores than participants without drug toxicity at all time points. However, only three participants with toxicity (27%) reported an actual decline in health-related quality of life by week 48. Drug toxicities had little impact on mental health summary scores.

Conclusion: These results confirm the health-related quality of life benefits of HAART. While the majority of patients experienced a significant improvement in health-related quality of life on HAART, up to a third of patients reported declines in this quality of life. This was largely related to better baseline clinical state. HAART-related drug toxicities did not have a significant impact on health-related quality of life during the first year of HAART, which supports the ongoing use of the current national first-line regimen.

No MeSH data available.


Related in: MedlinePlus

Change in median physical health summary score and median mental health summary score over the first 48 weeks of HAART.
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Figure 1: Change in median physical health summary score and median mental health summary score over the first 48 weeks of HAART.

Mentions: The physical health summary and mental health summary scores also showed an improvement in HRQoL over time (Figure 1). There was a significant increase in both summary scores between pre-HAART and week 16. The median PHS score increased from 45 to 53 units (p < 0.001) and the median MHS score increased from 45 to 51 units (p < 0.001). These increases were then maintained through weeks 32 and 48.


Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme.

Pitt J, Myer L, Wood R - J Int AIDS Soc (2009)

Change in median physical health summary score and median mental health summary score over the first 48 weeks of HAART.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2683808&req=5

Figure 1: Change in median physical health summary score and median mental health summary score over the first 48 weeks of HAART.
Mentions: The physical health summary and mental health summary scores also showed an improvement in HRQoL over time (Figure 1). There was a significant increase in both summary scores between pre-HAART and week 16. The median PHS score increased from 45 to 53 units (p < 0.001) and the median MHS score increased from 45 to 51 units (p < 0.001). These increases were then maintained through weeks 32 and 48.

Bottom Line: Overall, 23% of participants experienced a decline in their physical health summary score, while 34% showed a decline in the mental health summary score.Average drops in median physical and mental health summary scores were 8.4 units (SD 9.31) and 9.9 (SD 11.4) units respectively.This was largely related to better baseline clinical state.

View Article: PubMed Central - HTML - PubMed

Affiliation: Desmond Tutu HIV Foundation, Institute of Infectious Diseases and Molecular Medicine, Cape Town, South Africa. jennifer.pitt@hiv-research.org.za.

ABSTRACT

Background: The impact of highly active antiretroviral therapy (HAART) on health-related quality of life has been widely researched in the developed world, but there are few data from sub-Saharan Africa, where the vast majority of HIV-infected individuals live. This study examined health-related quality of life among HIV-positive individuals initiating HAART in Cape Town, South Africa, and explored the impact of HAART-related drug toxicities on quality of life.

Methods: Health-related quality of life was assessed using a standardised questionnaire, the Medical Outcomes Survey Short Form 36. Physical health summary scores and mental health summary scores were compared pre-HAART and at regular intervals during the first 48 weeks of HAART. The relationships between socio-demographic, baseline and on-treatment variables and decline in health-related quality of life, as well as the impact of drug toxicities on quality of life, were assessed in unadjusted bivariate and adjusted multivariate analyses.

Results: Two hundred and ninety-five patients were enrolled into the study. There was a significant increase in health-related quality of life during the first 48 weeks on HAART. The median physical health summary score increased from 45 to 53 units (p < 0.001) and median mental health summary score increased from 45 to 50 units (p < 0.001).The bulk of this increase occurred during the first 16 weeks. Overall, 23% of participants experienced a decline in their physical health summary score, while 34% showed a decline in the mental health summary score. Average drops in median physical and mental health summary scores were 8.4 units (SD 9.31) and 9.9 (SD 11.4) units respectively. Participants with drug toxicity had lower physical health summary scores than participants without drug toxicity at all time points. However, only three participants with toxicity (27%) reported an actual decline in health-related quality of life by week 48. Drug toxicities had little impact on mental health summary scores.

Conclusion: These results confirm the health-related quality of life benefits of HAART. While the majority of patients experienced a significant improvement in health-related quality of life on HAART, up to a third of patients reported declines in this quality of life. This was largely related to better baseline clinical state. HAART-related drug toxicities did not have a significant impact on health-related quality of life during the first year of HAART, which supports the ongoing use of the current national first-line regimen.

No MeSH data available.


Related in: MedlinePlus