Jia Huanguang, Uphold Constance R, Zheng Yu, Wu Samuel, Chen G John, Findley Kimberly, Duncan Pamela W
Department of Veterans Affairs Rehabilitation Outcomes Research Center, Gainesville, FL 32608-1197, USA.
Qual Life Res. 2007 Aug;16(6):961-8. doi: 10.1007/s11136-007-9214-4. Epub 2007 Apr 28.
This is the third study in a line of research which is designed to increase scientific understanding of the predictors of health-related quality of life (HRQOL) among men with HIV infection using data collected in large, prospective cohort study. Building on two prior investigations, this study examined the time-dependent relationships of psychosocial and clinical variables (active coping strategies, social support, CD4 cell count, comorbidity, and duration of HIV infection) and 10 HRQOL dimensions at two time points (baseline and 12 months). Using linear mixed models, we found that most relationships between the psychosocial and clinical variables and HRQOL dimensions were consistent across time. However, there were interactions between time and CD4 cell count and some HRQOL dimensions. Specifically, increased active coping and social support were positively related, whereas more comorbid conditions and longer HIV infection duration were negatively related with multiple HRQOL dimensions at both baseline and 12 months. CD4 cell count was positively associated with emotional well-being at both time points, but the associations between CD4 cell count and five HRQOL dimensions were negative at baseline but positive at 12 months. These findings provide additional support for the recommendation that clinicians and health planners should continually strive to enhance active coping strategies and social support, manage comorbid conditions, and incorporate duration of HIV diagnoses in their treatment plans. Because the relationships between CD4 cell count and HRQOL dimensions varied over time, it is important to recognize that results from laboratory tests (i.e., CD4 cell count) may have differential quality of life implications for patients at various times in their disease trajectories.
这是一系列研究中的第三项研究，该系列研究旨在利用在大型前瞻性队列研究中收集的数据，增强对感染艾滋病毒男性健康相关生活质量（HRQOL）预测因素的科学理解。基于之前的两项调查，本研究在两个时间点（基线和12个月）考察了心理社会和临床变量（积极应对策略、社会支持、CD4细胞计数、合并症以及艾滋病毒感染持续时间）与10个HRQOL维度之间的时间依存关系。使用线性混合模型，我们发现心理社会和临床变量与HRQOL维度之间的大多数关系在不同时间是一致的。然而，时间与CD4细胞计数以及一些HRQOL维度之间存在交互作用。具体而言，在基线和12个月时，积极应对的增加和社会支持呈正相关，而更多的合并症和更长的艾滋病毒感染持续时间与多个HRQOL维度呈负相关。在两个时间点，CD4细胞计数与情绪幸福感均呈正相关，但在基线时CD4细胞计数与五个HRQOL维度之间的关联为负，而在12个月时为正。这些发现为以下建议提供了额外支持：临床医生和健康规划者应不断努力增强积极应对策略和社会支持、管理合并症，并将艾滋病毒诊断的持续时间纳入其治疗计划。由于CD4细胞计数与HRQOL维度之间的关系随时间变化，重要的是要认识到实验室检查结果（即CD4细胞计数）可能在患者疾病轨迹的不同时间对生活质量产生不同的影响。
