What determines health-related quality of life among people living with HIV: an updated review of the literature

doi:10.1186/2049-3258-72-40

. 2014 Nov 17;72(1):40.

doi: 10.1186/2049-3258-72-40. eCollection 2014.

What determines health-related quality of life among people living with HIV: an updated review of the literature

Sophie Degroote¹, Dirk Vogelaers², Dominique M Vandijck³

Affiliations

¹ Department of General Internal Medicine, Infectious Diseases and Psychosomatics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
² Department of General Internal Medicine, Infectious Diseases and Psychosomatics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
³ Department of General Internal Medicine, Infectious Diseases and Psychosomatics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Economics, Faculty of Business Economics, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium.

PMID: 25671112
PMCID: PMC4323115
DOI: 10.1186/2049-3258-72-40

What determines health-related quality of life among people living with HIV: an updated review of the literature

Sophie Degroote et al. Arch Public Health. 2014.

. 2014 Nov 17;72(1):40.

doi: 10.1186/2049-3258-72-40. eCollection 2014.

Authors

Sophie Degroote¹, Dirk Vogelaers², Dominique M Vandijck³

Affiliations

¹ Department of General Internal Medicine, Infectious Diseases and Psychosomatics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
² Department of General Internal Medicine, Infectious Diseases and Psychosomatics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Internal Medicine, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium.
³ Department of General Internal Medicine, Infectious Diseases and Psychosomatics, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium ; Department of Economics, Faculty of Business Economics, Hasselt University, Agoralaan Building D, 3590 Diepenbeek, Belgium.

PMID: 25671112
PMCID: PMC4323115
DOI: 10.1186/2049-3258-72-40

Abstract

Background: As infection with the Human Immunodeficiency Virus (HIV) has evolved to a chronic disease, perceived health-related quality of life (HRQoL) is becoming a prominent and important patient-reported outcome measure in HIV care. Literature discusses different factors influencing HRQoL in this population, however, currently no consensus exists about the main determinants. In this review a clear, up-to-date overview of the determinants influencing HRQOL among people living with HIV is provided.

Methods: All studies published before July 2013 that identified determinants of HRQoL among people living with HIV in high-income countries, were considered in this narrative review. PubMed, Web of Science and The Cochrane Library were consulted using the keywords 'determinants', 'quality of life', 'HIV' and 'AIDS'. To be included, studies should have reported overall health and/or physical/mental health scores on a validated instrument and performed multivariable regression analyses to identify determinants that independently influence perceived HRQoL.

Results: In total, 49 studies were included for further analysis and they used a variety of HRQoL instruments: Medical Outcomes Study Short Form-36 or variants, Medical Outcomes Study-HIV, HIV Cost and Services Utilization Study measure, Multidimensional Quality of Life Questionnaire, HIV targeted quality of life instrument, Functional Assessment of Human Immunodeficiency Virus Infection, HIV Overview of Problems Evaluation System, EuroQol, Fanning Quality of Life scale, Health Index and PROQOL-HIV. In this review, the discussed determinants were thematically divided into socio-demographic, clinical, psychological and behavioural factors. Employment, immunological status, presence of symptoms, depression, social support and adherence to antiretroviral therapy were most frequently and consistently reported to be associated with HRQoL among people living with HIV.

Conclusions: HRQoL among people living with HIV is influenced by several determinants. These determinants independently, but simultaneously impact perceived HRQoL. Most HRQoL instruments do not capture all key determinants. We recommend that the choice for an instrument should depend on the purpose of the HRQoL assessment.

Keywords: Acquired immunodeficiency syndrome; Epidemiologic factors; HIV; Quality of life; Review.

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References

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[1] Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos P, D'Arminio Monforte A, Yust I, Bruun JN, Phillips AN, Lundgren JD. Changing patterns of mortality across Europe in patients infected with HIV-1. Lancet. 1998;352:1725–1730. doi: 10.1016/S0140-6736(98)03201-2. - DOI - PubMed

[2] Mocroft A, Vella S, Benfield TL, Chiesi A, Miller V, Gargalianos P, D'Arminio Monforte A, Yust I, Bruun JN, Phillips AN, Lundgren JD. Changing patterns of mortality across Europe in patients infected with HIV-1. Lancet. 1998;352:1725–1730. doi: 10.1016/S0140-6736(98)03201-2. - DOI - PubMed

[3] Palella FJ, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD, Investigators HOS. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. New Engl J Med. 1998;338:853–860. doi: 10.1056/NEJM199803263381301. - DOI - PubMed

[4] Palella FJ, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, Aschman DJ, Holmberg SD, Investigators HOS. Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. New Engl J Med. 1998;338:853–860. doi: 10.1056/NEJM199803263381301. - DOI - PubMed

[5] Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, Wagener MM, Singh N. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21–30. doi: 10.7326/0003-4819-133-1-200007040-00004. - DOI - PubMed

[6] Paterson DL, Swindells S, Mohr J, Brester M, Vergis EN, Squier C, Wagener MM, Singh N. Adherence to protease inhibitor therapy and outcomes in patients with HIV infection. Ann Intern Med. 2000;133:21–30. doi: 10.7326/0003-4819-133-1-200007040-00004. - DOI - PubMed

[7] Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, Bamberger JD, Chesney MA, Moss A. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. Aids. 2000;14:357–366. doi: 10.1097/00002030-200003100-00008. - DOI - PubMed

[8] Bangsberg DR, Hecht FM, Charlebois ED, Zolopa AR, Holodniy M, Sheiner L, Bamberger JD, Chesney MA, Moss A. Adherence to protease inhibitors, HIV-1 viral load, and development of drug resistance in an indigent population. Aids. 2000;14:357–366. doi: 10.1097/00002030-200003100-00008. - DOI - PubMed

[9] Kaplan RM, Ries AL. Quality of life: concept and definition. J Chron Obstruct Pulmon Dis. 2007;4:263–271. doi: 10.1080/15412550701480356. - DOI - PubMed

[10] Kaplan RM, Ries AL. Quality of life: concept and definition. J Chron Obstruct Pulmon Dis. 2007;4:263–271. doi: 10.1080/15412550701480356. - DOI - PubMed

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What determines health-related quality of life among people living with HIV: an updated review of the literature

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What determines health-related quality of life among people living with HIV: an updated review of the literature

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