Division of Infectious Diseases, Department of Internal Medicine, Academic Medical Center of the University of Amsterdam.
Stichting HIV Monitoring, Amsterdam.
AIDS. 2018 Jan 2;32(1):103-112. doi: 10.1097/QAD.0000000000001672.
The health-related quality of life (HRQOL) of people with HIV is lower than in the general population, but it is unknown how it compares with that of persons with other chronic medical conditions. We compared HRQOL in HIV with HRQOL in diabetes mellitus type 1, diabetes mellitus type 2 and rheumatoid arthritis (RA). In addition, we investigated factors associated with HRQOL in HIV.
Cross-sectional study.
HRQOL was measured with the Medical Outcomes Study Short Form 36-item Health Survey in a nationwide sample of people with HIV in care in the Netherlands and on combination antiretroviral therapy for at least 6 months. We added data from studies in diabetes mellitus types 1 and 2, and RA. Logistic regression analysis was used to examine: the association between disease group and a poor HRQOL, and patient factors associated with poor HRQOL in HIV.
The odds of a poor physical HRQOL in the HIV group were comparable with the odds in diabetes mellitus types 1 and 2, but lower than in RA patients. The odds of a poor mental HRQOL in HIV were higher than in the other groups. In HIV, a history of AIDS, longer duration of combination antiretroviral therapy and severe comorbidity were associated with a poor physical HRQOL. Sub-Saharan African descent and CD4 cell count of less than 350 cells/μl were associated with poor mental HRQOL.
People with HIV were more likely to have a poor mental HRQOL than patients with other chronic conditions. Addressing mental health should be an integral part of outpatient HIV care.
HIV 感染者的健康相关生活质量（HRQOL）低于一般人群，但尚不清楚其与其他慢性疾病患者的 HRQOL 相比如何。我们比较了 HIV 患者的 HRQOL 与 1 型糖尿病、2 型糖尿病和类风湿关节炎（RA）患者的 HRQOL。此外，我们还调查了与 HIV 患者 HRQOL 相关的因素。
横断面研究。
使用医疗结局研究简表 36 项健康调查（SF-36）对荷兰接受护理的 HIV 感染者和接受至少 6 个月联合抗逆转录病毒治疗的患者进行了全国性样本的 HRQOL 测量。我们添加了 1 型和 2 型糖尿病以及 RA 研究的数据。逻辑回归分析用于检查：疾病组与 HRQOL 较差之间的关联，以及与 HIV 患者 HRQOL 较差相关的患者因素。
HIV 组身体 HRQOL 较差的可能性与 1 型和 2 型糖尿病相似，但低于 RA 患者。HIV 组心理 HRQOL 较差的可能性高于其他组。在 HIV 中，艾滋病史、联合抗逆转录病毒治疗时间较长和严重合并症与身体 HRQOL 较差相关。撒哈拉以南非洲血统和 CD4 细胞计数低于 350 个/μl 与较差的心理 HRQOL 相关。
与其他慢性疾病患者相比，HIV 感染者更有可能出现较差的心理健康状况。解决心理健康问题应成为门诊 HIV 护理的一个组成部分。
