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20-02-2020

Predictors of health-related quality of life among military HIV-infected individuals

Authors: Leonard Emuren, Seth Welles, Grace Macalino, Alison A. Evans, Marcia Polansky, Anuradha Ganesan, Rhonda E. Colombo, Brian K. Agan, the Infectious Disease Clinical Research Program HIV Working Group

Published in: Quality of Life Research | Issue 7/2020

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Abstract

Objectives

To determine long-term predictors of health-related quality of life (HRQOL) and evaluate the treatment effect of highly active antiretroviral therapy (HAART) on HRQOL in the US Military HIV Natural History Study (NHS) cohort.

Methods

Participants were a nested cohort of the NHS who responded to the Rand Short Form 36 questionnaire administered from 2006 to 2010. Physical component summary scores (PCS) and mental component summary scores (MCS) were computed using standard algorithms. HAART-status was categorized as non-protease inhibitor-based (NPI-HAART), protease inhibitor-based (PI-HAART), HAART-naïve, or off-HAART. Mixed linear random effects models were used to estimate changes in PCS and MCS over time for treatment and covariates (including CD4 count, HIV viral load, medical and mental comorbidities).

Results

Eight hundred and twelve participants met the inclusion criteria. There was no difference in PCS or MCS between those on PI-HAART compared to NPI-HAART. Significant predictors of PCS were CD4 count < 200 cells/mm³ (β = − 2.90), CD4 count 200–499 cells/mm³ (β = − 0.80), and mental comorbidity (β = − 3.23). Others were medical comorbidity, AIDS-defining illness, being on NPI-HAART, HAART-naïve, age, and rank. Those with medical comorbidities experienced yearly improvement in PCS. Predictors of MCS were CD4 count < 200 cells/mm³ (β = − 2.53), mental comorbidity (β = − 4.58), and being African American (β = 2.59).

Conclusion

HRQOL was significantly affected by low CD4 count, medical and mental comorbidities. Addressing these modifiable factors would be expected to improve the physical and mental HRQOL of the cohort. Our study did not find any treatment benefit of NPI-HAART over PI-HAART on HRQOL in the long term.

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Title: Predictors of health-related quality of life among military HIV-infected individuals
Authors: Leonard Emuren
Seth Welles
Grace Macalino
Alison A. Evans
Marcia Polansky
Anuradha Ganesan
Rhonda E. Colombo
Brian K. Agan
the Infectious Disease Clinical Research Program HIV Working Group
Publication date: 20-02-2020
Publisher: Springer International Publishing
Published in: Quality of Life Research / Issue 7/2020
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-020-02441-5

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Abstract

Objectives

Methods

Results

Conclusion

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