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Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa
BACKGROUND: Antiretroviral treatment improves health related quality of life (HRQoL) of people with human immunodeficiency virus (PWH). However, one third initiating first-line treatment experience virological failure and the determinants of HRQoL in this key population are unknown. Our study aims t...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441724/ https://www.ncbi.nlm.nih.gov/pubmed/37605150 http://dx.doi.org/10.1186/s12955-023-02179-x |
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author | Rautenberg, Tamlyn A. Ng, Shu Kay George, Gavin Moosa , Mahomed-Yunus S. McCluskey, Suzanne M. Gilbert, Rebecca F. Pillay, Selvan Aturinda, Isaac Ard, Kevin L. Muyindike , Winnie R. Musinguzi, Nicholas Masette, Godfrey Pillay, Melendhran Moodley, Pravi Brijkumar, Jaysingh Gandhi, Rajesh T. Johnson, Brent Sunpath, Henry Bwana, Mwebesa B. Marconi, Vincent C. Siedner, Mark J. |
author_facet | Rautenberg, Tamlyn A. Ng, Shu Kay George, Gavin Moosa , Mahomed-Yunus S. McCluskey, Suzanne M. Gilbert, Rebecca F. Pillay, Selvan Aturinda, Isaac Ard, Kevin L. Muyindike , Winnie R. Musinguzi, Nicholas Masette, Godfrey Pillay, Melendhran Moodley, Pravi Brijkumar, Jaysingh Gandhi, Rajesh T. Johnson, Brent Sunpath, Henry Bwana, Mwebesa B. Marconi, Vincent C. Siedner, Mark J. |
author_sort | Rautenberg, Tamlyn A. |
collection | PubMed |
description | BACKGROUND: Antiretroviral treatment improves health related quality of life (HRQoL) of people with human immunodeficiency virus (PWH). However, one third initiating first-line treatment experience virological failure and the determinants of HRQoL in this key population are unknown. Our study aims to identify determinants of among PWH failing antiretroviral treatment in sub-Saharan Africa. METHODS: We analysed data from a cohort of PWH having virological failure (> 1,000 copies/mL) on first-line ART in South Africa and Uganda. We measured HRQoL using the EuroQOL EQ-5D-3L and used a two-part regression model to obtain by-country analyses for South Africa and Uganda. The first part identifies risk factors that were associated with the likelihood of participants reporting perfect health (utility = 1) versus non-perfect health (utility < 1). The second part identifies risk factors that were associated with the EQ-5 L-3L utility scores for participants reporting non-perfect health. We performed sensitivity analyses to compare the results between the two-part model using tobit models and ordinary least squares regression. RESULTS: In both countries, males were more likely to report perfect health and participants with at least one comorbidity were less likely to report perfect health. In South Africa, participants with side effects and in Uganda those with opportunistic infections were also less likely to report perfect health. In Uganda, participants with 100% ART adherence were more likely to report perfect health. In South Africa, high HIV viral load, experiencing ART side effects, and the presence of opportunistic infections were each associated with lower HRQoL, whereas participants with 100% ART adherence reported higher HRQoL. In Uganda participants with lower CD4 count had lower HRQoL. CONCLUSION: Markers of advanced disease (opportunistic infection, high viral load, low CD4), side effects, comorbidities and lack of ART adherence negatively impacted HRQoL for PWH experiencing virological failure. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02787499. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12955-023-02179-x. |
format | Online Article Text |
id | pubmed-10441724 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104417242023-08-22 Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa Rautenberg, Tamlyn A. Ng, Shu Kay George, Gavin Moosa , Mahomed-Yunus S. McCluskey, Suzanne M. Gilbert, Rebecca F. Pillay, Selvan Aturinda, Isaac Ard, Kevin L. Muyindike , Winnie R. Musinguzi, Nicholas Masette, Godfrey Pillay, Melendhran Moodley, Pravi Brijkumar, Jaysingh Gandhi, Rajesh T. Johnson, Brent Sunpath, Henry Bwana, Mwebesa B. Marconi, Vincent C. Siedner, Mark J. Health Qual Life Outcomes Research BACKGROUND: Antiretroviral treatment improves health related quality of life (HRQoL) of people with human immunodeficiency virus (PWH). However, one third initiating first-line treatment experience virological failure and the determinants of HRQoL in this key population are unknown. Our study aims to identify determinants of among PWH failing antiretroviral treatment in sub-Saharan Africa. METHODS: We analysed data from a cohort of PWH having virological failure (> 1,000 copies/mL) on first-line ART in South Africa and Uganda. We measured HRQoL using the EuroQOL EQ-5D-3L and used a two-part regression model to obtain by-country analyses for South Africa and Uganda. The first part identifies risk factors that were associated with the likelihood of participants reporting perfect health (utility = 1) versus non-perfect health (utility < 1). The second part identifies risk factors that were associated with the EQ-5 L-3L utility scores for participants reporting non-perfect health. We performed sensitivity analyses to compare the results between the two-part model using tobit models and ordinary least squares regression. RESULTS: In both countries, males were more likely to report perfect health and participants with at least one comorbidity were less likely to report perfect health. In South Africa, participants with side effects and in Uganda those with opportunistic infections were also less likely to report perfect health. In Uganda, participants with 100% ART adherence were more likely to report perfect health. In South Africa, high HIV viral load, experiencing ART side effects, and the presence of opportunistic infections were each associated with lower HRQoL, whereas participants with 100% ART adherence reported higher HRQoL. In Uganda participants with lower CD4 count had lower HRQoL. CONCLUSION: Markers of advanced disease (opportunistic infection, high viral load, low CD4), side effects, comorbidities and lack of ART adherence negatively impacted HRQoL for PWH experiencing virological failure. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02787499. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12955-023-02179-x. BioMed Central 2023-08-21 /pmc/articles/PMC10441724/ /pubmed/37605150 http://dx.doi.org/10.1186/s12955-023-02179-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Rautenberg, Tamlyn A. Ng, Shu Kay George, Gavin Moosa , Mahomed-Yunus S. McCluskey, Suzanne M. Gilbert, Rebecca F. Pillay, Selvan Aturinda, Isaac Ard, Kevin L. Muyindike , Winnie R. Musinguzi, Nicholas Masette, Godfrey Pillay, Melendhran Moodley, Pravi Brijkumar, Jaysingh Gandhi, Rajesh T. Johnson, Brent Sunpath, Henry Bwana, Mwebesa B. Marconi, Vincent C. Siedner, Mark J. Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa |
title | Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa |
title_full | Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa |
title_fullStr | Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa |
title_full_unstemmed | Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa |
title_short | Determinants of health-related quality of life in people with Human Immunodeficiency Virus, failing first-line treatment in Africa |
title_sort | determinants of health-related quality of life in people with human immunodeficiency virus, failing first-line treatment in africa |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441724/ https://www.ncbi.nlm.nih.gov/pubmed/37605150 http://dx.doi.org/10.1186/s12955-023-02179-x |
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