Health-Related Quality of Life After 1 Year of Highly Active Antiretroviral Therapy.

Carrieri, Patrizia; Spire, Bruno; Duran, Ségolène; Katlama, Christine; Peyramond, Dominique; François, Cécile; Chêne, Geneviève; Lang, Jean-Marie; Moatti, Jean-Paul; Leport, Catherine; the APROCO Study Group
JAIDS Journal of Acquired Immune Deficiency Syndromes:

Objective: We investigated the impact of the first year of highly active antiretroviral therapy (HAART) on health-related quality of life (HRQL).

Methods: Medical data for patients in the French APROCO cohort were collected at enrollment (MO) and month 12 (Ml2). A self-administered questionnaire gathered information about HRQL (Medical Outcome Study 36-Item Short Form Health Survey) and toxicity-related symptoms. Using the twenty-fifth percentile of HRQL scales in the French population as a threshold, patients with normal values in at least three mental and three physical scales were considered to have a "normal HRQL."

Results: Of the 1053 patients followed through M12, HRQL data at M0 and M12 were available for 654. Among the 233 patients with a normal baseline HRQL, 63 (27.0%) experienced a deterioration of HRQL at M12. Among the 421 patients with a low baseline HRQL, 121 achieved a normal HRQL at M12. Logistic regression showed that factors independently associated with a normal HRQL at M12 were normal baseline HRQL, baseline CD4 count <500 cells/mm3, time since HIV diagnosis <8 years, undetectable HIV-RNA at M12, and lower number of self-reported symptoms at M12.

Conclusion: An assessment of HRQL should be integrated to efficacy outcomes to evaluate and compare long-term strategies properly and to optimize the durability of response to antiretroviral therapy.

(C) 2003 Lippincott Williams & Wilkins, Inc.