Quality of life of people living with HIV/AIDS initiating antiretroviral therapy in the single tablet regimen era

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Background: Antiretroviral therapy (ART) has increased life expectancy of people living with HIV/ AIDS (PLHA). Single tablet regimens (STR) contributed to increase patient’s adherence to ART, but its influence in the quality of life (QoL) is still unknown. Objectives: To outline the profile and assess the QoL and associated factors of patients initiating ART in a reference hospital in Belo Horizonte, Brazil. Methods: Baseline evaluation of a cohort of 184 patients initiating ART between Sep/2015 and Aug/ 2016. We obtained sociodemographic, clinical and behavioral data through face-to-face interviews and used EuroQol5D-3L (EQ5D) and WHOQoLHIVbref instruments to assess QoL. We used non-parametric tests to compare QoL within groups using SPPS v21. Results: Patients were mainly men (79%), mean age of 35.9 ± 11.6 years old, unmarried (75%), nonbrowns (51%), had 9+ years of schooling (71%), were employed (81%) and with family income between 205 and 773 dollars (70%). In addition, 47% had children and 21% had health insurance. The majority was religious (78%) and had experienced in their lives alcohol (82%), tobacco (53%) or illicit drugs (46%). Median time of diagnosis and treatment was five and two months, respectively. Signs and symptoms of anxiety occurred in 37% of patients and of depression in 27%. About 84% used STR, 46% were adherent to ART and 75% reported at least one adverse reaction. Patients showed a good QoL in both instruments: EQ5D index (0.842 ± 0.146) and VAS (73.62 ± 21.3%). Average values of WHOQoLHIV-bref domains were 15.1 ± 3.2 (physical), 14.7 ± 2.8 (psychological), 14.7 ± 2.9 (independence), 14.7 ± 3.1 (social), 13.9 ± 2.5 (environment) and 14.5 ± 3.7 (spirituality). Patients in STR had higher Qol in EQ5D index (p = 0.02), VAS (p = 0.03) and in the WHOQoLHIV-bref independence domain (p < 0.01). Other factors influenced at least one domain: sex, age, marital status, schooling, health insurance, family income, religiousness, use of tobacco, signs and symptoms of anxiety and depression, time of treatment and of diagnosis, adverse reaction and adherence. Conclusions: QoL is influenced by the type of ART regimen and other sociodemographic, clinical and behavioral characteristics. This knowledge is useful to guide interventions to improve QoL of PLHA initiating ART.

Abstract

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HIV, AIDS, Terapia antirretroviral

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HIV, AIDS, Terapia antirretroviral

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https://onlinelibrary.wiley.com/doi/full/10.1002/pds.4275

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