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Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy
INTRODUCTION: Little is known about the well-being on long-term exposure to antiretroviral therapy. The ACTG Augmented Symptoms Distress Module (ASDM) is a validated tool which measures the presence of a total of 22 symptoms seen with HIV and quantifies the extent to which they cause distress to the...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International AIDS Society
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225276/ https://www.ncbi.nlm.nih.gov/pubmed/25397423 http://dx.doi.org/10.7448/IAS.17.4.19673 |
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author | Erdbeer, Gesa Sabranski, Michael Sonntag, Ina Stoehr, Albrecht Horst, Heinz-A. Plettenberg, Andreas Schewe, Knud Unger, Stefan Stellbrink, Hans-J. Fenske, Stefan Hoffmann, Christian |
author_facet | Erdbeer, Gesa Sabranski, Michael Sonntag, Ina Stoehr, Albrecht Horst, Heinz-A. Plettenberg, Andreas Schewe, Knud Unger, Stefan Stellbrink, Hans-J. Fenske, Stefan Hoffmann, Christian |
author_sort | Erdbeer, Gesa |
collection | PubMed |
description | INTRODUCTION: Little is known about the well-being on long-term exposure to antiretroviral therapy. The ACTG Augmented Symptoms Distress Module (ASDM) is a validated tool which measures the presence of a total of 22 symptoms seen with HIV and quantifies the extent to which they cause distress to the patient. METHODS: ELBE was a cross-sectional study that consecutively included adult HIV-infected patients presenting with viral suppression (<50 HIV RNA copies/mL) and ART exposure for at least five years. Patients were evaluated by four different questionnaires, including ASDM. RESULTS: Of a total of 894 patients included in the three participating ELBE centres, complete data on ASDM were available for 698 patients (626 male, 69 female, 3 transsexual). Median age was 49.7 years (range, 23.3–82.5 years) and median exposure to ART was 11.5 years (range, 5–28 years). Median CD4 T-cell counts had increased from a CD4 nadir of 180 to currently 640 cells/µL. Despite immunological and virological success, a high degree of symptom-related distress was noted in this patient population. In total, 63.8% and 36.3% of the patients had at least one “bothersome” or one “very bothersome” symptom, respectively. The symptoms most frequently reported to be “bothersome” or “very bothersome” were fatigue and energy loss (18.5% and 11.0% respectively), insomnia (12.8% and 11.6%), sadness and depression (13.0% and 10.0%), sexual dysfunction (12.0% and 10.0%), and changes in body appearance (11.0% and 10.9%). There was no association between the degree of symptom-related distress and gender, age or CD4 T-cell nadir. However, the history of AIDS-defining illnesses, comorbidities such as depression but also the duration of ART were significantly associated with a higher overall symptom summary score and with a higher frequency of symptoms. For example, in patients with at least 15 years of ART exposure, only 27.3% of the patients did not report at least one “bothersome” or “very bothersome” symptom. CONCLUSIONS: In this large group of positively selected HIV+ patients with virological success and long-term exposure to ART, a high degree of symptom-related distress was found. Medical care of HIV-infected patients should not only focus on optimal virological outcome. More data on quality of life in patients with long-term exposure to ART is needed. |
format | Online Article Text |
id | pubmed-4225276 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | International AIDS Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-42252762014-11-12 Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy Erdbeer, Gesa Sabranski, Michael Sonntag, Ina Stoehr, Albrecht Horst, Heinz-A. Plettenberg, Andreas Schewe, Knud Unger, Stefan Stellbrink, Hans-J. Fenske, Stefan Hoffmann, Christian J Int AIDS Soc Poster Sessions – Abstract P141 INTRODUCTION: Little is known about the well-being on long-term exposure to antiretroviral therapy. The ACTG Augmented Symptoms Distress Module (ASDM) is a validated tool which measures the presence of a total of 22 symptoms seen with HIV and quantifies the extent to which they cause distress to the patient. METHODS: ELBE was a cross-sectional study that consecutively included adult HIV-infected patients presenting with viral suppression (<50 HIV RNA copies/mL) and ART exposure for at least five years. Patients were evaluated by four different questionnaires, including ASDM. RESULTS: Of a total of 894 patients included in the three participating ELBE centres, complete data on ASDM were available for 698 patients (626 male, 69 female, 3 transsexual). Median age was 49.7 years (range, 23.3–82.5 years) and median exposure to ART was 11.5 years (range, 5–28 years). Median CD4 T-cell counts had increased from a CD4 nadir of 180 to currently 640 cells/µL. Despite immunological and virological success, a high degree of symptom-related distress was noted in this patient population. In total, 63.8% and 36.3% of the patients had at least one “bothersome” or one “very bothersome” symptom, respectively. The symptoms most frequently reported to be “bothersome” or “very bothersome” were fatigue and energy loss (18.5% and 11.0% respectively), insomnia (12.8% and 11.6%), sadness and depression (13.0% and 10.0%), sexual dysfunction (12.0% and 10.0%), and changes in body appearance (11.0% and 10.9%). There was no association between the degree of symptom-related distress and gender, age or CD4 T-cell nadir. However, the history of AIDS-defining illnesses, comorbidities such as depression but also the duration of ART were significantly associated with a higher overall symptom summary score and with a higher frequency of symptoms. For example, in patients with at least 15 years of ART exposure, only 27.3% of the patients did not report at least one “bothersome” or “very bothersome” symptom. CONCLUSIONS: In this large group of positively selected HIV+ patients with virological success and long-term exposure to ART, a high degree of symptom-related distress was found. Medical care of HIV-infected patients should not only focus on optimal virological outcome. More data on quality of life in patients with long-term exposure to ART is needed. International AIDS Society 2014-11-02 /pmc/articles/PMC4225276/ /pubmed/25397423 http://dx.doi.org/10.7448/IAS.17.4.19673 Text en © 2014 Erdbeer G et al; licensee International AIDS Society http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Poster Sessions – Abstract P141 Erdbeer, Gesa Sabranski, Michael Sonntag, Ina Stoehr, Albrecht Horst, Heinz-A. Plettenberg, Andreas Schewe, Knud Unger, Stefan Stellbrink, Hans-J. Fenske, Stefan Hoffmann, Christian Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy |
title | Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy |
title_full | Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy |
title_fullStr | Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy |
title_full_unstemmed | Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy |
title_short | Everything fine so far? Physical and mental health in HIV-infected patients with virological success and long-term exposure to antiretroviral therapy |
title_sort | everything fine so far? physical and mental health in hiv-infected patients with virological success and long-term exposure to antiretroviral therapy |
topic | Poster Sessions – Abstract P141 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4225276/ https://www.ncbi.nlm.nih.gov/pubmed/25397423 http://dx.doi.org/10.7448/IAS.17.4.19673 |
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