Department of Infectious Diseases, Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.
Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Breivika, 9037, Tromsø, Norway.
Health Qual Life Outcomes. 2023 Feb 15;21(1):14. doi: 10.1186/s12955-023-02098-x.
Despite the advances in the treatment of HIV, people living with HIV (PLHIV) still experience impairment of health-related quality of life (HRQOL). The aim of the study was to explore factors associated with HRQOL in a well-treated Norwegian HIV population.
Two hundred and forty-five patients were recruited from two outpatient clinics to participate in this cross-sectional study of addiction, mental distress, post-traumatic stress disorder, fatigue, somatic health, and HRQOL. The latter was measured using the 36-Item Short Form Health Survey (SF-36). Stepwise multiple linear regression analysis was used to examine the adjusted associations between demographic and disease-related variables and HRQOL.
The study population was virologically and immunologically stable. Their mean age was 43.8 (SD = 11.7) years, 131 (54%) were men, and 33% were native Norwegians. Compared with the general population (published in previous studies), patients reported worse SF-36 scores for five of eight domains: mental health, general health, social function, physical role limitation, and emotional role limitation (all p < 0.001). Compared with men, women reported better SF-36 scores within the domains vitality (63.1 (23.6) vs. 55.9 (26.7), p = 0.026) and general health (73.4 (23.2) vs. 64.4 (30.1), p = 0.009). In the multivariate analyses, higher SF-36- physical component score values were independently associated with young age (p = 0.020), being employed, student, or pensioner (p = 0.009), low comorbidity score (p = 0.015), low anxiety and depression score (p = 0.015), being at risk of drug abuse (p = 0.037), and not being fatigued (p < 0.001). Higher SF-36-mental component score values were independently associated with older age (p = 0.018), being from a country outside Europe or from Norway (p = 0.029), shorter time since diagnosis, low anxiety and depression score (p < 0.001), answering 'no' regarding alcohol abuse (p = 0.013), and not being fatigued (p < 0.001).
HRQOL was poorer in PLHIV than in the general population in Norway. It is important to focus on somatic and mental comorbidities when delivering health-care services in the ageing population of PLHIV to improve HRQOL even among a well-treated group of PLHIV as found in Norway.
尽管在治疗艾滋病方面取得了进展，但艾滋病毒感染者（PLHIV）的健康相关生活质量（HRQOL）仍受到损害。本研究的目的是探讨与挪威经治疗的 HIV 人群的 HRQOL 相关的因素。
从两家门诊诊所招募了 245 名患者参与这项关于成瘾、精神困扰、创伤后应激障碍、疲劳、躯体健康和 HRQOL 的横断面研究。后者使用 36 项简短健康调查（SF-36）进行测量。逐步多元线性回归分析用于检验人口统计学和疾病相关变量与 HRQOL 之间的调整关联。
研究人群的病毒学和免疫学稳定。他们的平均年龄为 43.8（标准差=11.7）岁，131 名（54%）为男性，33%为挪威本地人。与普通人群（以前的研究中发表）相比，患者在 8 个领域中的 5 个领域报告了更差的 SF-36 评分：心理健康、一般健康、社会功能、身体角色限制和情绪角色限制（均 p<0.001）。与男性相比，女性在活力（63.1（23.6）比 55.9（26.7），p=0.026）和一般健康（73.4（23.2）比 64.4（30.1），p=0.009）方面报告了更好的 SF-36 评分。在多变量分析中，SF-36 生理成分评分值较高与年龄较小（p=0.020）、就业、学生或退休人员（p=0.009）、低合并症评分（p=0.015）、低焦虑和抑郁评分（p=0.015）、有药物滥用风险（p=0.037）和不疲劳（p<0.001）独立相关。SF-36 心理成分评分值较高与年龄较大（p=0.018）、来自欧洲以外的国家或挪威（p=0.029）、诊断后时间较短、焦虑和抑郁评分较低（p<0.001）、回答“否”关于酒精滥用（p=0.013）和不疲劳（p<0.001）独立相关。
PLHIV 的 HRQOL 比挪威普通人群差。在为 PLHIV 这一老龄化人群提供医疗保健服务时，重要的是要关注躯体和精神合并症，以改善 HRQOL，即使在挪威这样的经治疗的 PLHIV 人群中也是如此。
