Health-related quality of life in perinatally HIV-infected children in the Netherlands

Abstract

Combination antiretroviral therapy (cART) can alter HIV infection in children into a chronic condition. Studies investigating health-related quality of life (HRQoL) in HIV-infected children are scarce, and lacking from Western Europe. This study aimed to compare the HRQoL of clinically stable perinatally HIV-infected children to healthy, socioeconomically (SES)-matched controls as well as the Dutch norm population, and to explore associations between HIV and cART-related factors with HRQoL. HIV-infected and healthy children aged 8–18 years completed the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™). We determined differences between groups on PedsQL™ mean scores, and the proportion of children with an impaired HRQoL per group (≥1 SD lower than the Dutch norm population). Logistic regression models were used to explore associations between disease-related factors and HRQoL impairment. In total, 33 HIV-infected and 37 healthy children were included. There were no differences in the mean PedsQL™ subscales between HIV-infected children and both control groups. The proportion of children with an impaired HRQoL was higher in the HIV-infected group (27%) as compared to the healthy control group (22%) and the Dutch norm (14%) on the school functioning subscale (HIV vs. Dutch norm: P = .045). Mean scores of HRQoL of perinatally HIV-infected children in the Netherlands were not different from a SES-matched control group, or from the Dutch norm population. However, the HIV-infected group did contain more children with HRQoL impairment, suggesting that HIV-infected children in the Netherlands are still more vulnerable to a compromised HRQoL.

Keywords:

• HIV
• cART
• health-related quality of life
• children
• Western Europe

Acknowledgements

We thank all study participants without whom this project would not have been possible. We are grateful to Dr Pythia Nieuwkerk for her valuable opinion and critical review of the manuscript. We thank the Dutch HIV Monitoring Foundation for their additional data collection and management.

Disclosure statement

S. C., J. A. t. S., A. M. W., A. v. d. P., T. W. K., H. J. S. and L. H. have no potential conflicts of interest. No potential conflict of interest was reported by the authors. P. R. has received research support through his institution from Gilead Sciences, Janssen Pharmaceuticals Inc., Merck & Co., Bristol-Meyers Squibb and ViiV Healthcare, and travel support through his institution from Gilead Sciences. D. P. has received research support and travel grants by AbbVie, Gilead Sciences and Viiv Healthcare.

Supplementary material

Supplementary (Table 1) is available via the “Supplementary” tab on the article's online page (http://dx.doi.org/10.1080/09540121.2015.1050986).

Additional information

Funding

This work was supported by the Emma Foundation [grant number 11.001].