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. 2013 Dec 18;16(1):18867.
doi: 10.7448/IAS.16.1.18867.

Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

Antoine Jaquet  1 , Franck Garanet  2 , Eric Balestre  3 , Didier K Ekouevi  4 , Jean Claude Azani  5 , René Bognounou  2 , Elias Dah  6 , Jean Charlemagne Kondombo  7 , François Dabis  3 , Joseph Drabo  2
Affiliations

Antiretroviral treatment and quality of life in Africans living with HIV: 12-month follow-up in Burkina Faso

Antoine Jaquet et al. J Int AIDS Soc. .

Abstract

Introduction: The scale-up of highly active antiretroviral therapy (HAART) has led to a significant improvement in survival of the HIV-positive patient but its effects on health-related quality of life (HRQOL) are less known and context-dependent. Our aim was to assess the temporal changes and factors associated with HRQOL among HIV-positive adults initiating HAART in Burkina Faso.

Methods: HIV-positive people initiating HAART were prospectively included and followed over a one-year period in three HIV clinics of Ouagadougou. HRQOL was assessed at baseline and at each follow-up visit using physical (PHS) and mental (MHS) summary scores derived from the Medical Outcome Study 36-Item short-form health survey (MOS SF-36) questionnaire. Toxicity related to HAART modification and self-reported symptoms were recorded during follow-up visits. Determinants associated with baseline and changes in both scores over a one-year period were assessed using a mixed linear model.

Results: A total of 344 patients were included. Their median age at baseline was 37 years [interquartile range (IQR) 30-44] and their median CD4 count was 181 cells/mm(3) (IQR 97-269). The mean [standard deviation (SD)] PHS score increased from 45.4 (11.1) at baseline to 60.0 (3.1) at 12 months (p <10(-4)) and the mean (SD) MHS score from 42.2 (8.7) to 43.9 (3.4) (p<10(-2)). After one year of treatment, patients that experienced on average two symptoms during follow-up presented with significantly lower PHS (63.9) and MHS (43.8) scores compared to patients that presented no symptoms with PHS and MHS of 68.2 (p<10(-4)) and 45.3 (p<10(-3)), respectively.

Discussion: The use of HAART was associated with a significant increase in both physical and mental aspects of the HRQOL over a 12-month period in this urban African population. Perceived symptoms experienced during follow-up visits were associated with a significant impairment in HRQOL. The appropriate and timely management of reported symptoms during the follow-up of HAART-treated patients is a key component to restore HRQOL.

Keywords: Burkina Faso; HIV/AIDS; antiretroviral treatment; quality of life; sub-Saharan Africa.

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Figures

Figure 1
Figure 1
Mean PHS and MHS scores at 12 month after HAART initiation according to the number of perceived symptoms estimated with the multivariable linear mixed models. The IeDEA West Africa collaboration, 2010–2011. PHS = physical health summary; MHS = mental health summary; HAART = highly active antiretroviral treatment.
See this image and copyright information in PMC

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