Predictors for lower quality of life in the HAART era among HIV-infected men
Predictors for lower quality of life in the HAART era among HIV-infected men
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DOI：
10.1097/01.qai.0000225730.79610.61
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发表时间：
2006-08-01
影响因子：
3.6
通讯作者：
Jacobson, Lisa P.
中科院分区：
文献类型：
--
作者：
Liu, Chenglong;Johnson, Lisette;Jacobson, Lisa P.
背景资料：在高效抗逆转录病毒治疗（HAART）时代，最大限度地提高健康相关的生活质量（QOL）已成为HIV感染者长期管理的高度优先事项。在多中心艾滋病队列研究中，对4个城市的男同性恋和男双性恋艾滋病感染者进行了一项纵向研究，目的：确定HAART使用者生活质量较低的预测因子。在多中心AIDS队列研究中，636例HAART使用受试者在HAART开始前有QOL数据，在HAART开始后至访视40（2004年4月）至少有2次连续QOL测量。使用随机效应混合模型评估社会人口统计学变量、个体风险行为、社会支持、生物学标志物、HIV相关药物使用和研究结果前的临床结果指标、来自标准SF-36 QOL表的身体健康总分和心理健康总分，作为可能的预测因素。HAART治疗前的生活质量是HAART治疗后生活质量的强预测因子。年龄较大、社会经济地位较低、男性性伴侣较少、不饮酒和HIV疾病分期较晚是身体健康综合评分较低的重要预测因素。此外，更多的门诊就诊，抑郁症，安普那韦的使用，抗逆转录病毒药物中断，娱乐性药物的使用，以及较少的社会支持与较低的心理健康汇总scores.Discussion：许多预测较低的生活质量是可变的危险因素，可以有效地针对干预措施，以最大限度地提高患者的生活质量。通过对艾滋病和抑郁症的适当治疗和管理，临床医生可以帮助改善患者的生活质量。通过改变个体的危险行为，HIV感染者可以在临床医生和社区的支持下提高自己的生活质量。此外，积极的社会支持也是改善感染者心理健康的有效途径。
Background: In the era of highly active antiretroviral therapy (HAART), maximizing health-related quality of life (QOL) has become a high priority of long-term management of HIV-infected individuals. Modifiable determinants of lower QOL should be identified for interventions specifically targeted to the HAART-using individuals to improve their QOL.Objective: To identify the predictors for lower QOL among HAART-using study participants in the Multicenter AIDS Cohort Study, a longitudinal study of HIV infection among homosexual and bisexual men in 4 cities.Methods: In the Multicenter AIDS Cohort Study, 636 HAART-using subjects had QOL data before HAART initiation and at least 2 consecutive QOL measurements after HAART initiation to visit 40 (April 2004). Variables of sociodemographics, individual risk behaviors, social support, biological markers, HIV-related medication use and clinical outcome indicators preceding the study outcomes, the physical health summary score and the mental health summary score derived from the standard SF-36 QOL form, were assessed as possible predictors using random-effects mixed models.Results: QOL before HAART initiation was a strong predictor of QOL subsequent to HAART initiation. Older age, lower socioeconomic status, less male sexual partners, no alcohol drinking, and more advanced HIV disease stage were significant predictors for lower physical health summary score. In addition, more outpatient visits, depression, amprenavir use, antiretroviral drug interruption, recreational drug use, and less social support were significantly associated with lower mental health summary score.Discussion: Many predictors of lower QOL are alterable risk factors that can be effectively targeted for interventions to maximize patients' QOL. With appropriate treatment and management of HIV disease and depression, clinicians can help improve the QOL of their patients. Through modification of individual risk behaviors, HIV-infected individuals can enhance their own QOL with support from clinicians and the community. In addition, active social support can also be an effective way to improve mental health of the infected persons.