抗逆转录病毒治疗开始后 HIV 感染患者健康相关生活质量的变化：一项纵向研究。
Changes health-related quality of life in HIV-infected patients following initiation of antiretroviral therapy: a longitudinal study.
机构信息
Universidade Federal da Bahia, Escola de Medicina, Salvador, BA, Brazil.
Complexo Hospitalar Universitário Professor Edgard Santos, Laboratório de Investigação em Doenças Infecciosas, Salvador, BA, Brazil.
出版信息
Braz J Infect Dis. 2019 Jul-Aug;23(4):211-217. doi: 10.1016/j.bjid.2019.06.005. Epub 2019 Jul 22.
BACKGROUND
Several tools have been developed to evaluate HIV health-related quality of life (HRQoL) during and after antiretroviral therapy (ART). Few longitudinal studies evaluated the effect of ART on the quality of life of HIV patients.
OBJECTIVE
To evaluate changes in HRQoL in HIV-infected individuals one year after initiating ART.
METHODS
A prospective study was conducted from May 2016 to July 2018. Data on clinical and sociodemographic characteristics of 91 HIV-infected patients were collected prior to initiation of ART and one year thereafter. Demographic and clinical data were collected and the questionnaires 36-item Short Form Health Survey (SF-36) and HIV/AIDS-targeted quality of life (HAT-QoL) were administered in both periods. Asymptomatic individuals, aged ≥18 years, were included in the study. Patients who discontinued treatment were excluded. The association between predictors of physical and mental HRQoL was analyzed by multiple linear regression analysis.
RESULTS
Patients were predominantly male (78.0%), mean age 35.3 ± 10.7 years, with no stable relationship (80.2%), and no comorbidities (73.6%). Most of the SF-36 domains improved after one year, particularly Physical Function (p = 0.0001), General Health (p = 0.0001), Social Functioning (p = 0.0001), Mental Health (p = 0.001), and Mental Component Summary (p = 0.004). HAT-QoL domains improved in the Overall Function (p = 0.0001), Life Satisfaction (p = 0.0001), Provider Trust (p = 0.001), and Sexual Function (p = 0.0001) domains. Sex (p = 0.032), age (p = 0.001), income (p = 0.007), and stable relationship (p = 0.004) were good predictors of the Physical Component Summary. Sex (p = 0.002) and stable relationship (p = 0.038) were good predictors of the Mental Component Summary. SF-36 and HAT-QoL scales presented strong correlations, except for Medication Concerns (0.15-0.37), HIV Mastery (0.18-0.38), Disclosure Worries (-0.15 to 0.07), and Provider Trust (-0.07 to 0.15).
CONCLUSIONS
ART improved HRQoL after one year of use. The HAT-QoL and SF-36 correlated well and are good tools to evaluate HRQoL in HIV-infected patients on ART.
背景
已经开发出几种工具来评估接受抗逆转录病毒疗法（ART）期间和之后与 HIV 相关的健康相关生活质量（HRQoL）。很少有纵向研究评估 ART 对 HIV 患者生活质量的影响。
目的
评估开始 ART 后一年 HIV 感染者 HRQoL 的变化。
方法
这是一项从 2016 年 5 月至 2018 年 7 月进行的前瞻性研究。在开始 ART 之前和之后一年收集了 91 名 HIV 感染者的临床和社会人口统计学特征数据。收集人口统计学和临床数据，并在两个时期进行 36 项简短健康调查（SF-36）和 HIV/AIDS 特定生活质量（HAT-QoL）问卷。纳入研究的是无症状、年龄≥18 岁的个体。排除停止治疗的患者。通过多元线性回归分析分析预测生理和心理 HRQoL 的因素之间的关联。
结果
患者主要为男性（78.0%），平均年龄 35.3±10.7 岁，无稳定关系（80.2%），无合并症（73.6%）。大多数 SF-36 领域在一年后有所改善，特别是身体功能（p=0.0001）、一般健康（p=0.0001）、社会功能（p=0.0001）、心理健康（p=0.001）和精神健康成分综合得分（p=0.004）。HAT-QoL 领域在整体功能（p=0.0001）、生活满意度（p=0.0001）、提供者信任（p=0.001）和性功能（p=0.0001）方面有所改善。性别（p=0.032）、年龄（p=0.001）、收入（p=0.007）和稳定关系（p=0.004）是精神成分综合得分的良好预测因素。性别（p=0.002）和稳定关系（p=0.038）是精神成分综合得分的良好预测因素。SF-36 和 HAT-QoL 量表相关性较强，除药物顾虑（0.15-0.37）、HIV 掌握度（0.18-0.38）、披露担忧（-0.15 至 0.07）和提供者信任（-0.07 至 0.15）外。
结论
ART 使用一年后改善了 HRQoL。HAT-QoL 和 SF-36 相关性良好，是评估接受 ART 的 HIV 感染者 HRQoL 的良好工具。
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