Epidemiology and Biostatistics, WHO, Bloemfontein, Free State, South Africa.
School of Public Health, Wits University, Johannesburg, South Africa.
BMC Infect Dis. 2022 May 12;22(1):456. doi: 10.1186/s12879-022-07429-9.
Studies which examine quality of life (QOL) provide important insights that are needed to understand the impacts of HIV/AIDS anti-retroviral treatment (ART), comorbid conditions and other factors on the daily activities of people living with HIV/AIDS (PLH). This study aimed to determine the inter-relationships between clinical factors, behavioural, socio-demographic variables and QOL among PLH.
The secondary analysis used data collected from 293 people living with HIV/AIDS (PLH) receiving second-line ART in Johannesburg in a clinical trial which evaluated the non-inferiority of ritonavir-boosted darunavir (DRV/r 400/100 mg) compared to ritonavir-boosted lopinavir (LPV/r) over a 48 week-period. Physical functioning, cognitive and mental QOL were measured using the Aids Clinical Trial Group questionnaire. Exploratory factor analyses were used to examine the structure, the relationships between and the construct validity of QOL items. Structural equation models which tested the a priori-hypothesised inter-relationships between QOL and other variables were estimated and goodness of fit of the models to the data was assessed.
Patients on darunavir presented with lower pill burden. Older patients and women were more likely to report lower QOL scores. Pill burden mediated the effects of age, sex and treatment regimen on physical functioning QOL and adverse effects; the effects of age, sex, treatment regimen and adverse effects on cognitive QOL; and the effects of sex on mental QOL.
QOL among PLH is associated with socio-demographic and clinical factors. Therefore, QOL could be enhanced by considering PLH characteristics, clinical factors such as regimen side-effects profile, management of comorbid conditions and mitigating risks such as potential adverse drug-to-drug interactions among patients on ART.
研究生活质量(QOL)可以提供重要的见解,这些见解对于理解 HIV/AIDS 抗逆转录病毒治疗(ART)、合并症和其他因素对 HIV/AIDS 患者(PLH)日常生活的影响是必要的。本研究旨在确定 PLH 临床因素、行为、社会人口统计学变量与生活质量之间的相互关系。
这项二次分析使用了在约翰内斯堡接受二线 ART 的 293 名 HIV/AIDS 患者(PLH)的临床试验数据,该试验评估了利托那韦增强型达芦那韦(DRV/r 400/100mg)与利托那韦增强型洛匹那韦(LPV/r)在 48 周内的非劣效性。使用艾滋病临床试验组问卷测量身体功能、认知和心理生活质量。采用探索性因子分析来检验生活质量项目的结构、关系和结构效度。估计了测试生活质量与其他变量之间预先假设的相互关系的结构方程模型,并评估了模型对数据的拟合程度。
接受达芦那韦治疗的患者的药物负担较低。年龄较大的患者和女性更有可能报告生活质量评分较低。药物负担介导了年龄、性别和治疗方案对身体功能生活质量和不良反应的影响;年龄、性别、治疗方案和不良反应对认知生活质量的影响;以及性别对心理生活质量的影响。
PLH 的生活质量与社会人口统计学和临床因素有关。因此,通过考虑 PLH 的特征、临床因素(如方案副作用特征)、合并症的管理以及减轻患者接受 ART 治疗时潜在的药物相互作用等风险,可以提高生活质量。