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Two measures of health-related quality of life in 65 HIV-infected individuals were compared in a cross-sectional design. The Quality of Well-Being Scale (QWB) results in a single score ranging from death to perfect health. The MOS-HIV Health Survey (MOS-HIV, 34-item version) gives scores in 11 dimensions. The QWB score distinguished subjects with AIDS from those who were asymptomatic (p = 0.027). For the seven multi-item scales of the MOS-HIV, Cronbach's alpha ranged from 0.85-0.95, indicating good internal consistency reliability. Clinical HIV-infection status was significantly associated with the dimensions of Overall Health (p = 0.002), Role Function (p = 0.022), Social Function (p = 0.037), Energy/Fatigue (p = 0.027) and Health Distress (p = 0.025). All eleven dimensions of the MOS-HIV were significantly correlated with the QWB score (Spearman's coefficient = 0.405-0.670; for all, p < 0.01) and the QWB score could be predicted from the MOS-HIV dimension scores using multiple regression. The QWB and the MOS-HIV may be useful in assessing health-related quality of life in patients infected with HIV.

beta-Carotene is a nontoxic carotenoid with immunomodulating properties in animals and humans. Based on our observations in normal immunocompetent subjects, we studied the effects of this compound in 11 patients infected with the human immunodeficiency virus (HIV). Each subject received 60 mg of beta-carotene daily for 4 mo. Clinical and laboratory studies were obtained at baseline, every month while on treatment and for 2 mo after treatment. Increases in the percent of cells expressing Leu 11 (natural killer cells), Ia antigen and transferrin receptor (activated lymphocytes) were observed after 3 mo of treatment with beta-carotene and diminished thereafter. Major changes were not seen in total lymphocyte count or in the percent of cells expressing CD11, CD8 or CD4 antigens. No clinical toxicity was observed. These data suggest that beta-carotene can modulate certain immune markers in HIV-infected subjects. Further study of this compound in HIV infection may be warranted.

The Subjective Global Assessment (SGA) tool is utilized by multiple disciplines to determine the nutritional status of a patient. In this study, the SGA was revised for specific use with patients infected with HIV. The revised SGA was used with 36 HIV-infected patients (35 males, 1 female) in a clinic setting for assessment of nutritional status. The authors describe the results of each section of the SGA (weight changes, dietary intake, gastrointestinal symptoms, functional impairment, and physical examination). The most severely malnourished HIV-infected patients presented with a higher frequency of weight loss and gastrointestinal symptoms, a greater degree of functional impairment and wasting, and lower albumin and CD4 lymphocyte values. The revised SGA is useful in identifying which patients need referral to a registered dietitian for further nutritional intervention, education, and follow-up. Utilization of the SGA represents a key opportunity for nurses and dietitians to work collaboratively for the benefit of the patient.