Quality of life in people living with HIV (the fourth 90) – are we there yet in Australia?

ABSTRACT

In 2014, UNAIDS outlined the 90-90-90 treatment targets. The “fourth 90” reflects the need to focus on optimising quality of life (HRQoL) in people living with HIV. Using a sample of non-heterosexual males in Melbourne, Australia, we aimed to assess HRQoL differences between HIV-positive and HIV-negative individuals, and identify factors that predict HRQoL both at baseline and after three years of follow up. Clinical information and patient-reported outcomes incorporating the Assessing Quality of Life-6D scale were collected at baseline and at three years. Sixty-two HIV-positive cases (antiretroviral therapy naïve at baseline) and 48 controls were enrolled. Results were compared between cases and controls at baseline, three-year follow-up, and between timepoints. HRQoL was significantly lower in cases compared to controls (83.5 (IQR 77.2–88.6) vs 87.3 (IQR 82.1–91.8), p = 0.022) at baseline, with increased depression and anxiety associated with reduced HRQoL in multivariate analysis. Mental health in cases improved between timepoints (75.0 (IQR 56.3–81.3) to 81.3 (IQR 62.5–81.3), p = 0.0428). No differences between the HRQoL of cases and controls were observed at three years. Increased mental health support may be required at commencement of antiretroviral therapy to enable similar levels of HRQoL between HIV-positive and HIV-negative individuals to be achieved.

KEYWORDS:

• Quality of life
• HIV
• cohort studies
• antiretroviral therapy
• AIDS

Acknowledgements

The study authors would like to acknowledge the input of clinical research coordinators Helen Lau, Janine Roney, Nigel Pratt and Jessica O-Bryan in managing the participants in the study, and Julian Elliott for his work in establishing the cohort.

Data availability statement

The data that support the findings of this study are available from the corresponding author, [MG], upon reasonable request.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by Alfred Research Trusts, Alfred Health, Burnet Institute, Monash University, Australian Centre for HIV and Hepatitis Virology Research and ViiV Healthcare.