Quality of life for children and adolescents: Impact of HIV infection and antiretroviral treatment
Quality of life for children and adolescents: Impact of HIV infection and antiretroviral treatment
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DOI：
10.1542/peds.2005-0323
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发表时间：
2006-02-01
期刊：
影响因子：
8
通讯作者：
Oleske, JM
中科院分区：
文献类型：
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作者：
Lee, GM;Gortmaker, SL;Oleske, JM
背景美国的HIV/AIDS死亡率正在下降;儿科HIV已成为一种慢性疾病，生活质量（QoL）结果变得更加重要。比较HIV感染和未感染儿童的生活质量，并评估不同抗逆转录病毒治疗方案对HIV感染儿童生活质量的影响。研究了围产期暴露、HIV感染（N = 1847）和未感染（N = 712）的儿童和青少年。在受感染的儿童中，有1283人可用于抗逆转录病毒疗法分析。评估了6个月至4岁、5至11岁和12至21岁受试者的生活质量领域评分，并评价了感染状态和替代治疗方案对生活质量领域的影响。艾滋病毒感染与6个月至4岁儿童的功能状态和5至11岁儿童的健康观念、身体复原力、身体功能和社会/角色功能的平均调整得分显著较差相关。然而，5至11岁的未感染儿童的心理功能明显较差。未接受抗逆转录病毒治疗的艾滋病毒感染儿童（5 - 11岁）和青少年（12 - 21岁）的健康状况较差。未接受抗逆转录病毒药物治疗的青少年症状也更严重。当比较抗逆转录病毒治疗方案时，与接受含蛋白酶抑制剂治疗的青少年相比，接受含蛋白酶抑制剂联合非核苷类逆转录酶抑制剂治疗的青少年症状更严重;除此之外，没有发现显著差异。一般来说，父母的艾滋病毒感染的儿童6个月至4岁和5至11岁，一般报告较低的平均生活质量分数比父母的未感染的儿童，虽然较差的心理功能，未感染的儿童。未接受抗逆转录病毒治疗的艾滋病毒感染青少年的健康观念和症状更差。我们发现接受不同抗逆转录病毒治疗方案的儿童之间没有一致的生活质量差异。
BACKGROUND. HIV/AIDS mortality rates in the United States are declining; pediatric HIV has become a chronic disease, with quality of life (QoL) outcomes assuming greater importance.OBJECTIVES. To compare QoL among HIV-infected and uninfected children and to assess the impact of different antiretroviral regimens on QoL among HIV-infected children.METHODS. Perinatally exposed, HIV-infected (N = 1847) and uninfected (N = 712) children and adolescents were studied. Among infected children, 1283 were available for the antiretroviral regimen analysis. QoL domain scores were assessed for subjects 6 months to 4 years, 5 to 11 years, and 12 to 21 years of age, and the impact of infection status and alternative treatment regimens on QoL domains was evaluated.RESULTS. HIV infection was associated with significantly worse mean adjusted scores for functional status among children 6 months to 4 years of age and health perceptions, physical resilience, physical functioning, and social/role functioning among those 5 to 11 years of age. However, uninfected children 5 to 11 years of age reported significantly worse psychological functioning. HIV-infected children (5 - 11 years of age) and adolescents (12 - 21 years of age) receiving no antiretroviral treatment had worse health perceptions. Adolescents receiving no antiretroviral agents also had worse symptoms. When antiretroviral regimens were compared, adolescents receiving protease inhibitor plus nonnucleoside reverse transcriptase inhibitor-containing therapy had worse symptoms, compared with those receiving protease inhibitor-containing therapy; otherwise, no significant differences were found.CONCLUSIONS. Generally parents of HIV-infected children 6 months to 4 years and 5 to 11 years of age generally reported lower mean QoL scores than did parents of uninfected children, although worse psychological functioning was reported for uninfected children. HIV-infected adolescents not receiving antiretroviral treatment had worse health perceptions and symptoms. We found no consistent QoL differences among children receiving different antiretroviral regimens.