Préau M, Protopopescu C, Spire B, Dellamonica P, Poizot-Martin I, Villes V, Carrieri M P
INSERM U379/ORS-PACA, Marseille.
Rev Epidemiol Sante Publique. 2006 Jul;54 Spec No 1:1S33-1S43.
To assess factors associated with higher levels of health-related quality-of-life among HIV-HCV co-infected injecting drug users and more specifically, to explore the role of injecting drug status and drug maintenance treatment on health-related quality-of-life.
The two hundred and forty participants were patients enrolled in the MANIF cohort of HIV-HCV patients infected through injecting drug use who completed a self-administered questionnaire that included a health-related quality-of-life evaluation at the 42 month follow-up. A self-administered questionnaire collected information about socio-demographic characteristics, health-related quality-of-life (as measured by SF-12), injecting drug status and drug maintenance treatment, depressive symptoms, self-reported symptoms related to HIV treatment; clinical characteristics were obtained from medical records.
Higher levels of both mental and physical health-related quality-of-life were found in patients with no depressive symptoms, abstinent from drugs and experiencing few drug related problems. Patients on drug maintenance treatment who stopped injecting drugs had better mental health-related quality-of-life than injectors but lower levels of mental health-related quality-of-life than abstinent patients. Mental health-related quality-of-life was also independently higher in patients receiving high social support. Physical health-related quality-of-life was independently higher for patients who stopped injection, whether on drug maintenance treatment or not, for patients on anti-retroviral treatment and for patients who remained in clinical stage A.
Drug maintenance treatment seems to be associated with higher health-related quality-of-life among patients HIV-HCV co-infected by drug use, but it is still necessary to help patients cope with the mental impact of drug cessation. These results underline the need to provide regular psychological support and counselling for HIV-HCV co-infected injecting drug users during the medical follow-up for HIV-disease.
评估与艾滋病毒-丙型肝炎病毒合并感染的注射吸毒者中较高水平的健康相关生活质量相关的因素，更具体地说，探讨注射吸毒状况和药物维持治疗对健康相关生活质量的作用。
240名参与者是通过注射吸毒感染艾滋病毒-丙型肝炎病毒的MANIF队列中的患者，他们完成了一份自我管理的问卷，其中包括在42个月随访时进行的健康相关生活质量评估。一份自我管理的问卷收集了社会人口学特征、健康相关生活质量（通过SF-12测量）、注射吸毒状况和药物维持治疗、抑郁症状、自我报告的与艾滋病毒治疗相关的症状等信息；临床特征从医疗记录中获取。
在没有抑郁症状、戒毒且药物相关问题较少的患者中，发现心理健康相关生活质量和身体健康相关生活质量水平较高。接受药物维持治疗且停止注射吸毒的患者心理健康相关生活质量优于仍在注射吸毒的患者，但低于戒毒患者。接受高社会支持的患者心理健康相关生活质量也独立较高。停止注射吸毒的患者，无论是否接受药物维持治疗，接受抗逆转录病毒治疗的患者以及处于临床A期的患者，身体健康相关生活质量独立较高。
药物维持治疗似乎与因吸毒导致艾滋病毒-丙型肝炎病毒合并感染患者较高的健康相关生活质量相关，但仍有必要帮助患者应对戒毒的心理影响。这些结果强调了在艾滋病毒疾病的医学随访期间，为艾滋病毒-丙型肝炎病毒合并感染的注射吸毒者提供定期心理支持和咨询的必要性。
