Health-related quality of life among HIV-infected patients initiating treatment in Brazil in the single-tablet regimen era

ABSTRACT

Health-related quality of life (HRQoL) is a multidimensional concept involving an individual’s self-perception about how a disease or treatment impacts their daily life. In this study, we evaluated the HRQoL and factors associated with this outcome in 366 patients initiating combination Antiretroviral Therapy (cART) in Belo Horizonte, Brazil.We measured HRQoL using the EuroQoL-5D 3 level (EQ-5D) and the HIV instrument of the World Health Organization (WHOQOL-HIV BREF) and identified factors associated with HRQoL using multilevel linear regression. Participants had been on cART treatment a median of 65.5 days at the time the instruments were completed. The median HRQoL of patients on the single-tablet regimen containing efavirenz/ tenofovir/ lamivudine and the multi-tablet regimen containing dolutegravir and tenofovir/ lamivudine were high, with no significant difference between groups. Factors consistently associated with lower HRQoL were being single (unmarried), having a lower educational level, recent cigarette smoking, recent signs and symptoms of anxiety or depression, comorbid disease and the occurrence of adverse drug reactions. We observed high levels of HRQoL in cART-treated people and no differences between dolutegravir and efavirenz-based regimens. This study provides inputs to future economic analysis and identifies opportunities to increase the HRQoL of patients by targeting modifiable factors.

KEYWORDS:

• Antiretroviral therapy
• highly active
• HIV
• quality of life
• patient-reported outcome measures

Acknowledgments

The authors are grateful for the financial support provided by the scientific research support institutions.

Contributors: All authors have contributed significantly to this study and are aware of and agree with this submission. J.O.C. carried out the data collection, data analysis, and interpretation, write-up of the article and approval of final version for publication. S.A.P. contributed towards the analysis design, data interpretation, critical revision of relevant content and approval of the final version for publication. F.A.A. contributed towards the project design, critical revision of relevant content and approval of the final version for publication. P.F.B. and M.R.S. contributed towards the data interpretation, article write-up, and approval of the final version for publication. M.G.B.C. contributed towards the project design, carried out the data interpretation, critical revision of relevant content and approval of the final version for publication, as well as overseeing all stages of the research to guarantee the precision and integrity of all elements of the study.

Disclosure statement

No potential conflict of interest was reported by the authors.

ORCID

Juliana de Oliveira Costa http://orcid.org/0000-0002-8355-023X

Sallie Anne Pearson http://orcid.org/0000-0001-7137-6855

Francisco de Assis Acurcio http://orcid.org/0000-0002-5880-5261

Palmira de Fátima Bonolo http://orcid.org/0000-0003-2744-7139

Micheline Rosa Silveira http://orcid.org/0000-0001-7002-4428

Maria das Graças Braga Ceccato http://orcid.org/0000-0002-4340-0659

Additional information

Funding

This study was carried out by the UFMG with financial support from the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) grant number CDS-APQ-03938-16, Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) finance code 001, and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).