Ndubuka Nnamdi O, Lim Hyun J, van der Wal Dirk M, Ehlers Valerie J
Department of Health Studies, University of South Africa, South Africa.
Northern Inter-Tribal Health Authority, Prince Albert, South Africa.
South Afr J HIV Med. 2016 Oct 31;17(1):475. doi: 10.4102/sajhivmed.v17i1.475. eCollection 2016.
Antiretroviral therapy (ART) improves patients' health-related quality of life (HRQoL). Defaulting from ART has detrimental consequences, including the development of viral resistance, treatment failure and increased risks of disease progression. Little is known about the quality of life of ART defaulters and reasons for discontinuing their ART.
This study sought to measure the HRQoL of ART patients in Botswana who were on ART for up to 5 years but had discontinued treatment for at least 3 months, and to identify factors associated with ART defaulting.
We conducted a cross-sectional study with 104 eligible respondents in four ART clinics in south eastern Botswana. We assessed respondents' HRQoL using the World Health Organization Quality of Life Questionnaire for HIV short form. Clinical information was obtained from respondents' medical records. Data were analysed using SAS version 9.2.
Reasons for discontinuing ART were inaccessible clinics (22.4%), feeling better (21.4%), running out of pills (11.2%), depression (8.2%), lack of care and/or support (8.2%), failure to understand instructions (7.7%), medications' side effects (6.1%) and alcohol abuse (3.1%). In multivariate analyses, respondents aged 36-45 years had a 0.03 lower independence HRQoL score compared to those aged 35 and younger (β = -0.03; 95% confidence interval: -1.72, -1.66). Despite defaulting from their ART, respondents' calculated HRQoL scores were moderate.
This study highlights the need to enhance ART adherence in order to improve the HRQoL of people living with HIV and/or AIDS.
抗逆转录病毒疗法（ART）可改善患者的健康相关生活质量（HRQoL）。中断ART治疗会产生有害后果，包括病毒耐药性的产生、治疗失败以及疾病进展风险增加。对于中断ART治疗者的生活质量以及停止治疗的原因，我们知之甚少。
本研究旨在衡量博茨瓦纳接受ART治疗长达5年但已中断治疗至少3个月的患者的HRQoL，并确定与ART治疗中断相关的因素。
我们在博茨瓦纳东南部的四家ART诊所对104名符合条件的受访者进行了横断面研究。我们使用世界卫生组织HIV生活质量简表评估受访者的HRQoL。临床信息从受访者的病历中获取。数据使用SAS 9.2版进行分析。
中断ART治疗的原因包括诊所难以到达（22.4%）、感觉好转（21.4%）、药物用完（11.2%）、抑郁（8.2%）、缺乏护理和/或支持（8.2%）、不理解用药说明（7.7%）、药物副作用（6.1%）和酗酒（3.1%）。在多变量分析中，36 - 45岁的受访者与35岁及以下的受访者相比，其独立性HRQoL得分低0.03（β = -0.03；95%置信区间：-1.72，-1.66）。尽管中断了ART治疗，但受访者计算得出的HRQoL得分中等。
本研究强调需要加强ART治疗的依从性，以改善艾滋病毒和/或艾滋病感染者的HRQoL。
