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.
This study was supported by the Agence Nationale de Recherches sur le Sida (ANRS, Action Coordonnée no. 7), Association des Professeurs de Pathologie Infectieuse et Tropicale (APPIT), and associated pharmaceutic companies (Abbott, Boehringer-Ingelheim, Roche, Bristol-Myers Squibb Pharma, Merck Dohm Chibret, and GlaxoSmith- Kline).
Address correspondence and reprint requests to Bruno Spire, INSERM U379, 23 rue Stanislas Torrents, 13006 Marseille, France; e-mail: firstname.lastname@example.org.
Manuscript received August 8, 2002; accepted October 18, 2002.
© 2003 Lippincott Williams & Wilkins, Inc.