Health-Related Quality of Life Among People Living with Human Immunodeficiency Virus on Highly Active Antiretroviral Therapy in Ethiopia: PROQOL-HIV Based Survey

埃塞俄比亚接受高效抗逆转录病毒疗法的艾滋病毒感染者健康相关生活质量:基于PROQOL-HIV的调查

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Abstract

BACKGROUND: As infection with the Human Immunodeficiency Virus (HIV) has evolved into a chronic disease, perceived health-related quality of life (HRQoL) is becoming a prominent and important patient-reported outcome measure in HIV care. This study aimed to assess HRQoL among people living with HIV on highly active antiretroviral therapy and factors associated with HRQoL in Ethiopia. METHODS: An institution-based cross-sectional study was conducted among 160 HIV-infected patients who were initiated highly active antiretroviral therapy at Jimma University Medical Center in 2016. HRQoL was assessed using the patient-reported outcome quality of life-HIV (PROQOL-HIV) measuring scale. Linear regressions were used to identify factors associated with outcome. Statistical significance was considered at p-value <0.05. RESULTS: Out of a total of 160 participants, 63.13% were females. The mean (±SD) age of study participants was 41.47±9.45 years. The median baseline CD(4)+ cell count was 182.00 cells/µL (IQR: 104.53-262.40 cells/µL). The mean (±SD) score of PROQOL-HIV scale domains was 77.58 ±15.11, 58.32 ±7.79, 61.75± 17.95, 85.07 ±15.67, 76.92 ± 20.52, 80.00 ±16.83, 74.37 ± 1.47, 81.45 ± 8.17 for physical health and symptoms, emotional distress, health concerns, body change, intimate relationships, social relationships, stigma, and treatment impact domains, respectively. Second line antiretroviral therapy showed a negative effect on the quality of life, especially on the treatment impact domain (β=-6.301). Cotrimoxazole preventive therapy had a significant positive effect on the physical health and symptoms of HIV patients (β= +8.381, p<0.05). Advanced disease (β=-2.709, p<0.05), and non-communicable disease comorbidity (β=-14.340, p<0.001) showed a significant negative effect on physical health and symptoms. CONCLUSION: Several behavioral, clinical & immunological factors were negatively associated with health-related quality of life. The double burden of chronic non-communicable disease(s) and the impact of treatment were highly significant in all dimensions of HRQoL measures. Therefore, with HRQoL emerging as a key issue for HIV-infected patients, its routine assessment and appropriate interventions at each clinic visit would be very crucial.

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