Fan Angela Pei-Chen, Kuo Huai-Ching Claire, Kao Diana Yu-Ting, Morisky Donald E, Chen Yi-Ming Arthur
Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.
AIDS Care. 2011 Mar;23(3):287-302. doi: 10.1080/09540121.2010.507742.
Malawi is a sub-Saharan African nation with a severe HIV epidemic. The quality of life (QoL) has never been investigated among people living with HIV and AIDS (PLWHA) in Malawi. This study examines the QoL and associated factors including life needs among PLWHA at different stages of their illness in the northern region of Malawi.
Survey analysis of consecutive outpatient participants receiving highly active antiretroviral therapy at the Rainbow Clinic and non-HIV patients receiving care at the affiliated Mzuzu Central Hospital during a one-month period was performed. Laboratory testing and clinical diagnosis were used to determine HIV status, determine CD4 count, and classify WHO clinical stage. A total of 267 HIV-infected patients and 598 non-HIV participants completed a needs assessment and a Short Form-36 (SF-36) questionnaire, which contained a QoL subscale. SF-36 subscales and needs assessment scores were analyzed using t-test, ANOVA test, and Generalized Linear Model-Tukey's test.
HIV-positive patients had significantly lower physical functioning (p=0.0365), mental health (p=0.001), social functioning (p<0.0001), and mental component summary (p=0.0069) scores than HIV-negative patients. Further, WHO Stage III HIV patients had significantly lower vitality (p=0.0439) and mental health (p=0.0022) scores than WHO Stages I and II patients; and WHO Stage IV patients had significantly lower vitality (p=0.0015), mental health (p=0.0006), and physical component summary (p=0.0443) scores than WHO Stages I and II patients. Finally, AIDS patients, as determined by CD4 count, had significantly lower bodily pain (p=0.0423) and physical component summary (p=0.0148) scores than non-AIDS, HIV-positive patients.
HIV patients undergoing treatment in Malawi have a significantly lower QoL, both mentally and physically, than their non-HIV counterparts. Further, HIV patients at more advanced stages, both by the WHO definition and by CD4 count, have a significantly lower QoL than HIV patients at earlier stages of the disease.
马拉维是撒哈拉以南非洲的一个国家,艾滋病疫情严重。马拉维从未对艾滋病毒和艾滋病患者(PLWHA)的生活质量(QoL)进行过调查。本研究调查了马拉维北部地区不同疾病阶段的艾滋病毒和艾滋病患者的生活质量及其相关因素,包括生活需求。
对在彩虹诊所接受高效抗逆转录病毒治疗的连续门诊参与者以及在附属的姆祖祖中心医院接受治疗的非艾滋病毒患者进行了为期一个月的调查分析。通过实验室检测和临床诊断来确定艾滋病毒感染状况、测定CD4细胞计数并对世界卫生组织(WHO)临床分期进行分类。共有267名艾滋病毒感染患者和598名非艾滋病毒参与者完成了需求评估和包含生活质量子量表的简短健康调查问卷(SF-36)。使用t检验、方差分析(ANOVA)和广义线性模型-图基检验对SF-36子量表和需求评估得分进行分析。
艾滋病毒阳性患者的身体功能(p = 0.0365)、心理健康(p = 0.001)、社会功能(p < 0.0001)和心理综合得分(p = 0.0069)显著低于艾滋病毒阴性患者。此外,WHO临床III期艾滋病毒患者的活力(p = 0.0439)和心理健康(p = 0.0022)得分显著低于WHO临床I期和II期患者;WHO临床IV期患者的活力(p = 0.0015)、心理健康(p = 0.0006)和身体综合得分(p = 0.0443)显著低于WHO临床I期和II期患者。最后,根据CD4细胞计数确定的艾滋病患者的身体疼痛(p = 0.0423)和身体综合得分(p = 0.0148)显著低于非艾滋病的艾滋病毒阳性患者。
在马拉维接受治疗的艾滋病毒患者在心理和身体方面的生活质量显著低于非艾滋病毒患者。此外,无论是根据WHO定义还是CD4细胞计数处于更晚期的艾滋病毒患者,其生活质量显著低于疾病早期的艾滋病毒患者。