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. 2020 Jul;29(7):1855-1869.
doi: 10.1007/s11136-020-02441-5. Epub 2020 Feb 20.

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

Leonard Emuren  1   2   3 , Seth Welles  1 , Grace Macalino  4   5 , Alison A Evans  1 , Marcia Polansky  1 , Anuradha Ganesan  4   5   6 , Rhonda E Colombo  4   5   7 , Brian K Agan  8   9 ; Infectious Disease Clinical Research Program HIV Working Group
Collaborators, Affiliations

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

Leonard Emuren et al. Qual Life Res. 2020 Jul.

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.

Keywords: HIV; Health-related quality of life; Highly active antiretroviral therapy; Mental component summary scores; Physical component summary scores.

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Conflict of interest statement

Conflict of Interest: All of the authors declare no competing interests or financial interest in this work. All authors contributed to the content of the manuscript and concurred with the decision to submit it for publication.

Figures

Fig. 1.
Fig. 1.
a-dPhysical Component Summary Scores by HAART Group Over Four Years of Follow-up. (a) unadjusted PCS of participants by HAART group (b) unadjusted PCS of participants on PI-HAART or NPI-HAART (c) unadjusted PCS of participants on PI-HAART or HAART-NAÏVE (d) unadjusted PCS of participants on PI-HAART or OFF-HAART; raw means are shown.
Fig. 2.
Fig. 2.
a-dMental Component Summary Scores by HAART Group Over Four Years of Follow-up. (a) unadjusted MCS of participants by HAART group (b) unadjusted MCS of participants on PI-HAART or NPI-HAART (c) unadjusted MCS of participants on PI-HAART or HAART-NAÏVE (d) unadjusted MCS of participants on PI-HAART or OFF-HAART; raw means are shown.
See this image and copyright information in PMC

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