PISCIS队列中年龄≥60岁的HIV感染者健康相关生活质量较差的预测因素：Vive+项目的研究结果

Predictors of poor health-related quality of life among people living with HIV aged ≥60 years in the PISCIS cohort: Findings from the Vive+ project.

作者信息

Bruguera Andreu, Egea-Cortés L, Mesías-Gazmuri J, Palacio-Vieira J, Forero C G, Miranda C, Saumoy M, Fernández E, Navarro G, Orti A, Miró J M, Casabona J, Reyes-Urueña J

机构信息

Methodology of Biomedical Research and Public Health, Department of Pediatrics, Obstetrics and Gynecology, Preventive Medicine, and Public Health, Univ Autonoma de Barcelona, Badalona, Spain.

Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.

出版信息

HIV Med. 2024 Apr;25(4):424-439. doi: 10.1111/hiv.13590. Epub 2023 Dec 13.

DOI:10.1111/hiv.13590

PMID:38092529

Abstract

INTRODUCTION

Advancements in and accessibility to effective antiretroviral therapy has improved the life expectancy of people living with HIV, increasing the proportion of people living with HIV reaching older age (≥60 years), making this population's health-related quality of life (HRQoL) more relevant. Our aim was to identify the determinants of poor HRQoL in people living with HIV aged ≥60 years and compare them with those of their younger counterparts.

METHODS

We used data from the 'Vive+' study, a cross-sectional survey conducted between October 2019 and March 2020, nested within the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands, Spain. We used the 12-item short-form survey (SF-12), divided into a physical component summary (PCS) and a mental component summary (MCS), to evaluate HRQoL. We used the least absolute shrinkage and selection operator for variable selection and used multivariable regression models to identify predictors.

RESULTS

Of the 1060 people living with HIV (78.6% males) who participated in the study, 209 (19.7%) were aged ≥60 years. When comparing older people living with HIV (≥60 years) and their younger counterparts, older people exhibited a worse PCS (median 51.3 [interquartile range {IQR} 46.0-58.1] vs. 46.43 [IQR 42.5-52.7], p < 0.001) but a similar MCS (median 56.0 [IQR 49.34-64.7] vs. 57.0 [IQR 48.9-66.3], p = 0.476). In the multivariable analysis, cognitive function correlated with a PCS (β correlation factor [β] -0.18, p = 0.014), and depressive symptoms and satisfaction with social role correlated with an MCS (β 0.61 and β -0.97, respectively, p < 0.001) in people living with HIV aged ≥60 years.

CONCLUSION

Depressive symptoms, poor cognitive function, and lower satisfaction with social roles predict poorer HRQoL in older people living with HIV. These factors need to be considered when designing targeted interventions.

摘要

引言

高效抗逆转录病毒疗法的进步及其可及性提高了艾滋病毒感染者的预期寿命，使达到老年（≥60岁）的艾滋病毒感染者比例增加，这使得该人群的健康相关生活质量（HRQoL）更受关注。我们的目的是确定60岁及以上艾滋病毒感染者HRQoL较差的决定因素，并将其与年轻感染者的决定因素进行比较。

方法

我们使用了“Vive+”研究的数据，这是一项于2019年10月至2020年3月进行的横断面调查，嵌套于西班牙加泰罗尼亚和巴利阿里群岛艾滋病毒感染者的PISCIS队列中。我们使用12项简短调查问卷（SF-12），分为身体成分总结（PCS）和心理成分总结（MCS），来评估HRQoL。我们使用最小绝对收缩和选择算子进行变量选择，并使用多变量回归模型来确定预测因素。

结果

在参与研究的1060名艾滋病毒感染者（78.6%为男性）中，209名（19.7%）年龄≥60岁。在比较老年艾滋病毒感染者（≥60岁）和年轻感染者时，老年感染者的PCS较差（中位数51.3[四分位间距{IQR}46.0 - 58.1] vs. 46.43[IQR 42.5 - 52.7]，p < 0.001），但MCS相似（中位数56.0[IQR 49.34 - 64.7] vs. 57.0[IQR 48.9 - 66.3]，p = 0.476）。在多变量分析中，认知功能与60岁及以上艾滋病毒感染者的PCS相关（β相关系数[β] -0.18，p = 0.014），抑郁症状和对社会角色的满意度与MCS相关（β分别为0.61和 -0.97，p < 0.001）。