TY - JOUR
T1 - Predictors of health-related quality of life among military HIV-infected individuals
AU - The Infectious Disease Clinical Research Program HIV Working Group
AU - Emuren, Leonard
AU - Welles, Seth
AU - Macalino, Grace
AU - Evans, Alison A.
AU - Polansky, Marcia
AU - Ganesan, Anuradha
AU - Colombo, Rhonda E.
AU - Agan, Brian K.
AU - De Leon, S.
AU - Merritt, S.
AU - Merritt, T.
AU - Okulicz, J.
AU - Sjoberg, T.
AU - Baker, C.
AU - Chambers, S.
AU - Colombo, R.
AU - Ferguson, T.
AU - Kunz, A.
AU - Schofield, C.
AU - Stein, M.
AU - Powers, J.
AU - Tramont, E.
AU - Banks, S.
AU - Kronmann, K.
AU - Lalani, T.
AU - Tant, R.
AU - Warkentien, T.
AU - Cammarata, S.
AU - Kirkland, N.
AU - Maves, R.
AU - Utz, G.
AU - Price, M.
AU - Chu, X.
AU - Estupigan, C.
AU - Horton, W.
AU - Hsieh, H.
AU - Noiman, A.
AU - Parmelee, E.
AU - Tribble, D.
AU - Wang, X.
AU - Won, S.
AU - Crowell, T.
AU - Peel, S.
AU - Barahona, I.
AU - Blaylock, J.
AU - Decker, C.
AU - Ganesan, A.
AU - Ressner, R.
AU - Wallace, D.
N1 - Publisher Copyright:
© 2020, Springer Nature Switzerland AG.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - HIV
KW - Health-related quality of life
KW - Highly active antiretroviral therapy
KW - Mental component summary scores
KW - Physical component summary scores
UR - http://www.scopus.com/inward/record.url?scp=85079822734&partnerID=8YFLogxK
U2 - 10.1007/s11136-020-02441-5
DO - 10.1007/s11136-020-02441-5
M3 - Article
C2 - 32076926
AN - SCOPUS:85079822734
SN - 0962-9343
VL - 29
SP - 1855
EP - 1869
JO - Quality of Life Research
JF - Quality of Life Research
IS - 7
ER -