Quality of Life Among HIV-Infected Patients in Brazil after Initiation of Treatment

Abstract

INTRODUCTIONDespite improvement in clinical treatment for HIV-infected patients, the impact of antiretroviral therapy on the overall quality of life has become a major concern.OBJECTIVETo identify factors associated with increased levels of self-reported quality of life among HIV-infected patients after four months of antiretroviral therapy.METHODSPatients were recruited at two public health referral centers for AIDS, Belo Horizonte, Brazil, for a prospective adherence study. Patients were interviewed before initiating treatment (baseline) and after one and four months. Quality of life was assessed using a psychometric instrument, and factors associated with good/very good quality of life four months after the initiation of antiretroviral therapy were assessed using a cross-sectional approach. Logistic regression was used for analysis.RESULTSOverall quality of life was classified as ‘very good/good’ by 66.4% of the participants four months after initiating treatment, while 33.6% classified it as ‘neither poor nor good/poor/very poor’. Logistic regression indicated that >8 years of education, none/mild symptoms of anxiety and depression, no antiretroviral switch, lower number of adverse reactions and better quality of life at baseline were independently associated with good/very good quality of life over four months of treatment.CONCLUSIONSOur results highlight the importance of modifiable factors such as psychiatric symptoms and treatment-related variables that may contribute to a better quality of life among patients initiating treatment. Considering that poor quality of life is related to non-adherence to antiretroviral therapy, careful clinical monitoring of these factors may contribute to ensuring the long-term effectiveness of antiretroviral regimens.

Sexual orientation and quality of life of people living with HIV/Aids

“…In spite of the heterogeneity observed in the population in general, studies show large groups of vulnerability inside this global epidemic, such as the population of men who have sex with men, sex workers, and population deprived of freedom, which are segments often marginalized in societies (2)(3) . In Brazil, where high rates of incidence are found (3) , universal access to antiretroviral therapy provided a change in the perception of the disease, which changed its status from a fatal disease to a chronic health condition (4) . Access to treatment, good adherence to antiretroviral therapy and an increase in diagnosis have caused impacts on the quality of life of these people, leading to an increase in survival time, reduction in morbidity and mortality, increase in life expectancy, and redefinition of future projects (5) .…”

Redistribuição de gordura corporal e alterações no metabolismo de lipídeos e glicose em pessoas vivendo com HIV/AIDS

“…In the 1990s, with the advent of combined highly active antiretroviral therapy (HAART), it was possible to reduce the mortality and morbidity of AIDS and allows for a better quality of life for those with HIV 3 . Despite their benefits and efficacy, the interaction between HAART with the infection itself and inflammation caused by HIV is associated with severe adverse effects, such as metabolic alterations and abnormal redistribution of body fat.…”

Impact Factors of Quality of Life among HIV/AIDS Patients after Antiretroviral Therapy: A Cohort Study Systematic Review

“…Some studies indicated that HIV/AIDS patients with more education gained more knowledge about HIV/AIDS to adjust their living situation; higher income patients would have improved material lives [20]. In other words, patients with higher monthly incomes had more financial flexibility, which enabled them to adapt to the life-altering disease [14,18]. Clinical characteristics negatively associated with QOL included more symptoms, adverse effects, lower CD4 cell counts, and higher viral loads.…”

“…Last-visit QOL scores were analyzed in seven of the studies [9,12,13,[16][17][18]20]; the ratio of good/normal QOL at the last visit was analyzed in two studies [14,21], and QOL change was analyzed in four studies [10,11,15,19]. Among the predictors, job stability and social support associated positively with QOL.…”