Change in clinical status, health status, and health utility outcomes in HIV-infected patients

Abstract

Psychometric health status scales and health utility scales were compared to measure the impact of changes in clinical status in patients infected with the human immunodeficiency virus (HIV). The data used included the first two waves of a longitudinal study of 160 HIV-infected patients, a population that was 34% women and 65% African American. The Medical Outcome Study-HIV Health Survey (MOS-HIV); sleep, cognitive function, and depression scales; the Sickness Impact Profile Home Management Scale; and questions on HIV-related clinical symptoms were administered. Standard gamble utilities and categorical rating scale preferences were assessed for current health state. The MOS-HIV scale scores of asymptomatic patients were significantly higher than those of symptomatic patients and patients with acquired immune deficiency syndrome. No differences were observed for utilities. Increases in clinical symptoms over 4 months were associated with changes in health perception, pain, physical role function, social function, mental health, depression, energy, cognitive function, and categorical rating scale preferences. The MOS-HIV and other health status measures discriminated between HIV disease stages and were associated with clinical status. Standard gamble utilities did not discriminate among the three groups and were not correlated with clinical status.