Department of Epidemiology, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
Department of Biostatistics, University of Nebraska Medical Center, Omaha, Nebraska, United States of America.
PLoS One. 2021 Apr 1;16(4):e0248802. doi: 10.1371/journal.pone.0248802. eCollection 2021.
The association between HIV-associated neurocognitive impairment (NCI) and health-related quality of life (HRQoL) is not well known. We investigated this association among the CNS (Central Nervous System) HIV Antiretroviral Therapy Effects Research (CHARTER) study participants. We performed factor analysis to distinguish physical and mental HRQoL, followed by general linear models. We analyzed 1,340 HIV participants, including 35.6% with NCI, 77.2% males, 70.5% unemployed, and 42.2% with depression. Impaired participants had lower (worse) mental and physical HRQoL mean scores compared to unimpaired participants. NCI was negatively associated with mental HRQoL in crude (mean difference: -4.38; 95% CI: -6.70 to -2.06) and adjusted analysis (-2.56, -4.83 to -0.30). NCI was also negatively associated with physical HRQoL in unadjusted analysis (-4.62, -7.45 to -1.78), though the association weakened in the adjusted analysis (-2.20, -4.81 to 0.40). The association between NCI and HRQoL was confounded mainly by employment and was partially mediated by depression. These findings suggest that future strategies aimed at improving HRQoL among HIV-infected patients with NCI might benefit from concurrent management of depression.
HIV 相关认知障碍（NCI）与健康相关生活质量（HRQoL）之间的关联尚不清楚。我们在 CNS（中枢神经系统）HIV 抗逆转录病毒治疗效果研究（CHARTER）参与者中调查了这种关联。我们进行了因子分析以区分身体和心理 HRQoL，然后进行了一般线性模型分析。我们分析了 1340 名 HIV 参与者，其中 35.6%有 NCI，77.2%为男性，70.5%失业，42.2%有抑郁。与无认知障碍的参与者相比，认知障碍参与者的心理和身体 HRQoL 平均得分较低（较差）。NCI 与心理健康 HRQoL 呈负相关，在未调整分析中（平均差异：-4.38；95%CI：-6.70 至-2.06）和调整分析中（-2.56，-4.83 至-0.30）均如此。在未调整分析中，NCI 与身体 HRQoL 也呈负相关（-4.62，-7.45 至-1.78），但在调整分析中，这种关联减弱（-2.20，-4.81 至 0.40）。NCI 与 HRQoL 之间的关联主要受就业状况混杂，部分受抑郁状况中介。这些发现表明，未来旨在改善患有 NCI 的 HIV 感染患者 HRQoL 的策略可能受益于同时管理抑郁。
