Background
With bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF), and dolutegravir/lamivudine (DTG/3TC) included in the national drug reimbursement list, the integrase strand transfer inhibitor (INSTI)-based regimens could be afforded and used by more patients. Majority of previous health-related quality of life (HRQoL) studies were conducted before INSTI-based regimens reimbursed and have no restriction on the regimens received. The aim of the study is to measure the HRQoL of HIV patients with INSTI-based regimens in China.
Methods
A cross-sectional survey of HIV patients conducted in the First Hospital of Changsha. Adult patients diagnosed with HIV-1 infection between January 1st, 2021-July 31st, 2022, with the prescription of BIC/FTC/3TC or DTG/3TC as the current treatment were included. Patients’ responses were collected through a digital platform and the HRQoL were measured by three questionnaires, including HIV-symptom index (HIV-SI) questionnaire, Patient Health Questionnaire‐9 (PHQ-9) and the five-level version of the EuroQol five-dimensional questionnaire (EQ-5D-5L). Generalized linear regression model was used to estimate the effects of covariates on each HRQoL measure.
Results
A total of 143 HIV patients with HRQoL data available were included in the study. The mean (SD) of HIV-SI total score, PHQ-9 total score and EQ-5D utility score was 26.7 (14.4), 7.4 (1.0) and 0.95 (0.12), respectively. Compared with treatment-naive patients, treatment-experienced patients reported significantly higher score/proportion of HIV-SI and PHQ-9 total score, presence of depression and problems in anxiety/depression (all p<0.05). Patients with older age, without formal work, having treatment switch due to safety reason and lower CD4 cell counts had significantly higher HIV symptom burden and worse depression status, respectively (all p<0.05).
Conclusions
HIV patients suffer from HIV symptoms and depression, which greatly deteriorate their HRQoL. Considering the aging population and lower employment rate, the needs for social support or patient-assistant program for HIV patients are highlighted. The early initiation of INSTI-based regimens is necessary to avoid the HRQoL loss due to safety reasons.