Margalho Renata, Pereira Marco, Ouakinin Sílvia, Canavarro Maria Cristina
Associação para o Desenvolvimento e Investigação, Faculdade de Medicina de Lisboa, Lisboa, Portugal.
Acta Med Port. 2011 Dec;24 Suppl 2:539-48. Epub 2011 Dec 31.
Patient adherence to highly active antiretroviral therapy (HAART) is essential to treatment success, and improved quality of life (QoL) and mental health have been recognized as important outcomes from the HIV treatment. However, very few published research studies have related these domains to HAART adherence. The purpose of this study was to examine the association between adherence to HAART, QoL and psychopathological symptoms in a sample of HIV-infected patients, and to identify demographic, clinical and psychological predictors of non-adherence.
A cross-sectional study was conducted in the main services/departments of infectious diseases of Portuguese Hospitals. The sample consisted of 762 HIV-infected patients. The assessment protocol included the Portuguese versions of the WHOQOLHIV-Bref and the Brief Symptom Inventory (BSI).
Of the 762 patients, 133 (17.5%) reported not to fully adhere to HIV medication. Non-adherent patients reported significantly lower QoL. Follow-up tests reported significant differences in four of six domains, with the exception of Social relationships and Spirituality domains. Regarding psychopathological symptoms, there was also a significant effect. Follow-up tests reported a significant difference only on psychoticism. In multivariate logistic regression, younger individuals, people diagnosed and on medication for longer time, with lower CD4+ T cell count, on symptomatic/AIDS stage and with higher scores on interpersonal sensitivity, anxiety and psychoticism were more likely to be non-adherents.
Future studies assessing HAART adherence should consider the interplay of demographic and HIV-related variables, as well as psychological status. Also, it may help to elicit those people who are at risk for non-adherence, as well as poorer quality of life and mental health.
患者坚持高效抗逆转录病毒疗法（HAART）对治疗成功至关重要，生活质量（QoL）的改善和心理健康已被视为HIV治疗的重要成果。然而，很少有已发表的研究将这些领域与HAART依从性联系起来。本研究的目的是在一组HIV感染患者样本中，检验HAART依从性、生活质量和心理病理症状之间的关联，并确定不依从的人口统计学、临床和心理预测因素。
在葡萄牙医院的主要传染病科室进行了一项横断面研究。样本包括762名HIV感染患者。评估方案包括世界卫生组织生活质量HIV简表（WHOQOLHIV-Bref）和简明症状量表（BSI）的葡萄牙语版本。
在762名患者中，133名（17.5%）报告未完全坚持服用HIV药物。不依从的患者报告生活质量显著较低。后续测试报告六个领域中有四个领域存在显著差异，社会关系和精神领域除外。关于心理病理症状，也有显著影响。后续测试仅报告在精神病性方面存在显著差异。在多因素逻辑回归中，年龄较小、诊断和用药时间较长、CD4+T细胞计数较低、处于有症状/艾滋病阶段以及人际敏感性、焦虑和精神病性得分较高的个体更有可能不依从。
未来评估HAART依从性的研究应考虑人口统计学和HIV相关变量以及心理状态的相互作用。此外，这可能有助于找出那些有不依从风险以及生活质量和心理健康较差的人群。
