Health-related quality of life (HRQoL) from HIV patients’ perspective: comparison of patient-reported outcome (PRO) measures among people living with hiv (PLWH) and other chronic clinical conditions

Abstract

Background People living with HIV (PLWH) are generally known to suffer from a lower quality of life compared to the one of general population, but still very few is known about the self-perception of quality of life when comparing HIV to non-communicable diseases. We performed a comprehensive assessment of patient’s reported outcomes measures (PROMs) among PLWH and patients affected by other chronic conditions (OC) such as diabetes mellitus type 1, rheumatoid arthritis, breast cancer in hormonal therapy, in order to investigate differences in PROMs outcomes between PLWH and other pathologies. Methods A cross-sectional observational study was performed by using questionnaires investigating health-related quality of life (Medical Outcomes Study Short Form 36-item Health Survey), work productivity (WPI), and global health status (EQ-5D-3L). They were administered to patients affected by chronic diseases consecutively observed at a single University Hospital during a 10 months period, with comparable disease related aspects. Logistic regression analysis was used to analyze the association between disease group (HIV vs OC) and PROMs. Results 230 patients were enrolled (89 PLWH, 143 OC). Mean age: 49 years (SD 10), mean time of disease 12 years (10), 96% were Caucasian, 35% assumed polypharmacy, 42% of male were PLWH versus 16% OC (p < 0.001), 19% PLWH versus 6% OC had clinical complications (p < 0.001). HIV infection was independently associated to a better health-related quality of life in several domains compared with the other conditions, except in mental health, whereas a worst health-related quality of life in most domains was reported by older patients and those experiencing polypharmacy. Conclusions In this cohort of patients with chronic conditions followed within the same health setting, PLWH showed better self-reported health outcomes compared to other chronic conditions with comparable characteristics of chronicity. The potential detrimental role of older age and polypharmacy in most outcomes suggests the need of longitudinal assessment of PROMs in clinical practice.

Healthcare Resource Consumption and Related Costs in Patients on Antiretroviral Therapies: Findings from Real-World Data in Italy

“…The demographic characteristics of the overall ART population reported a male predominance and a mean age of around 49 years, which is in line with other Italian real-world studies on HIV [1,23]. Hypertension and dyslipidemia were among the most frequent comorbidities detected; a French study also observed these two conditions to be highly prevalent in PLWH [24].…”

“…The development and introduction of antiretroviral therapies (ART) and then the availability of combination ART in the clinical practice has dramatically changed the course of human immunodeficiency virus (HIV) infection from an acute to a chronic disease [1]. Nowadays, life expectancy for people living with HIV (PLWH) is up to that of the general population in those patients who receive a prompt diagnosis and early treatment and achieve adequate viral-load suppression [2].…”

HIV-Specific Reported Outcome Measures: Systematic Review of Psychometric Properties

“…The advantage of a generic PROM is that it enables researchers to compare the health outcomes of people living with HIV and AIDS with those of other populations based on the same measurements [16]. However, unlike generic PROMs, HIV-specific PROMs do not have a significant ceiling and floor effect and do not overestimate health outcomes in people living with HIV and AIDS [17,18]. Furthermore, HIV-specific PROMs are more closely associated with HIV than are generic PROMs.…”

Perceived Health Status, Quality of Life and Treatment-Seeking Behaviour Among People Living with HIV/AIDS (PLHIV) Attending Antiretroviral Therapy Clinic at a Tertiary Care Centre of North India

“…1,4 Though the survival is prolonged, still PLHIV continue to suffer from many physical problems including side effects of therapy like pain and fatigue, etc., mental health issues like depression and social issues like isolation. 5,6,7 All these things determine their health status and impact the quality of life (QOL) of PLHIV. 8 As per the World Health Organization (WHO), 'Quality of Life is an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns'.…”