Briongos-Figuero Laisa Socorro, Bachiller-Luque Pablo, Palacios-Martín Teresa, de Luis-Román Daniel Antonio, Eiros-Bouza José María
Medicina Familiar y Comunitaria, Servicio de Medicina Interna, Hospital Universitario del Río Hortega, Valladolid, España.
Enferm Infecc Microbiol Clin. 2011 Jan;29(1):9-13. doi: 10.1016/j.eimc.2010.06.006. Epub 2011 Jan 3.
Access to antiretroviral treatment (ART) has become essential to delay HIV clinical progression and increase survival, so improving Health Related Quality of Life (HRQL). The aim of this investigation was to describe factors associated with ART and their impact on HRQL in HIV infected patients.
A cross-sectional study on 150 HIV-outpatients in a tertiary hospital was designed, and ART-related data collected. Adherence was assessed by the SMAQ questionnaire. HRQL data were collected by disease-specific questionnaire MOS-HIV (Medical Outcomes Study HIV Health Survey).
A total of 84% of patients were on ART. Half of the treatment regimens were Protease inhibitor (PI) based, LPV/r being the most commonly used drug. The large majority of treatments used (89.7%) were second line or successive, and NNRTI-based combinations were the most used in first line. Lipodystrophy was the most frequently referred side-effect (61.1%). Almost all (94.5%) of our patients declared they were adapting well to treatment in their daily-life-activities, with 64.3% adhering to treatment according to the SMAQ (Simplified Medication Adherence Questionnaire) questionnaire. In the HRQL, patients with PI-based treatment got lower scores in 4 of 11 domains with the MOS-HIV questionnaire; while patients that adapted well to their ART had better scores in 4 of 11 domains and overall HRQL assessment in MOS-HIV.
Most of our patients were on ART during our investigation. We have documented a negative association between PI-based treatment and HRQL domains, and a positive association between subjective ART adaptation and HRQL. The assessment of HRQL in this population has increasing interest as it is influenced by ART related factors as treatment improves life conditions of HIV infected people.
获得抗逆转录病毒治疗（ART）已成为延缓HIV临床进展和提高生存率的关键，从而改善健康相关生活质量（HRQL）。本研究旨在描述与ART相关的因素及其对HIV感染患者HRQL的影响。
设计了一项针对一家三级医院150名HIV门诊患者的横断面研究，并收集了与ART相关的数据。通过SMAQ问卷评估依从性。HRQL数据通过特定疾病问卷MOS-HIV（医学结局研究HIV健康调查）收集。
共有84%的患者接受ART治疗。一半的治疗方案以蛋白酶抑制剂（PI）为基础，洛匹那韦/利托那韦（LPV/r）是最常用的药物。绝大多数使用的治疗方案（89.7%）为二线或后续治疗，一线治疗中最常用的是以非核苷类逆转录酶抑制剂（NNRTI）为基础的联合用药。脂肪代谢障碍是最常提及的副作用（61.1%）。几乎所有（94.5%）的患者表示他们在日常生活活动中能很好地适应治疗，根据简化药物依从性问卷（SMAQ），64.3%的患者坚持治疗。在HRQL方面，使用基于PI治疗的患者在MOS-HIV问卷的11个领域中的4个领域得分较低；而在ART治疗中适应良好的患者在MOS-HIV问卷的11个领域中的4个领域以及总体HRQL评估中得分较高。
在我们的研究期间，大多数患者接受了ART治疗。我们记录了基于PI的治疗与HRQL领域之间的负相关，以及主观ART适应性与HRQL之间的正相关。随着ART相关因素影响HIV感染者的生活状况，对该人群HRQL的评估越来越受到关注。
