Quality of life improvement in resource-limited settings after one year of second-line antiretroviral therapy use among adult men and women.

Journal: AIDS (London, England)

Volume: 32

Issue: 5

Year of Publication: 2019

Affiliated Institutions:  Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. Asociación Civil Impacta Salud y Educación, Lima, Peru. LAPCLIN-AIDS, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. AMPATH at Moi University Teaching Hospital, Eldoret, Kenya. Durban Adult HIV CRS, Durban. Wits Health Consortium Department of Medicine, University of Witwatersrand, Johannesburg, South Africa. Department of Medicine, University of Washington, Seattle, Washington, USA.

Abstract summary 

We evaluated improvement of quality of life (QoL) after 1 year of second-line antiretroviral therapy (ART) use in resource-limited settings (RLS) among adult men and women, comparing two randomized treatment arms.The AIDS Clinical Trial Group A5273 was a randomized clinical trial of second-line ART comparing lopinavir/ritonavir (LPV/r) + raltegravir with LPV/r + nucleos(t)ide reverse transcriptase inhibitors (NRTIs) in participants failing a non-NRTI-containing regimen at 15 sites in nine RLS. Participants completed the AIDS Clinical Trial Group short-form-21 which has eight QoL domains with a standard score ranging from 0 (worst) to 100 (best).Differences in QoL by randomized arm, as well as by demographic and clinical variables, were evaluated by regression models for baseline and week 48 QoL scores fitted using the generalized estimating equations method.A total of 512 individuals (49% men, median age 39 years) were included. A total of 512 and 492 participants had QoL assessments at baseline and week 48, respectively. QoL improved significantly from baseline to week 48 (P < 0.001 for all domains). There was no significant difference between treatment arms for any domain. Individuals with higher viral load and lower CD4 cell count at baseline had lower mean QoL at baseline but larger improvements such that mean QoL was similar at week 48.Improvements in QoL were similar after starting second-line ART of LPV/r combined with either raltegravir or NRTIs in RLS. QoL scores at baseline were lower among participants with worse disease status prior to starting second-line, but after 1 year similar QoL scores were achieved.

Authors & Co-authors:  Torres Harrison La Rosa Cardoso Zheng Ngongondo Some Lalloo Mwelase Collier Hughes

Study Outcome 

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Statistics
Citations :  Lima VD, Hogg RS, Harrigan PR, Moore D, Yip B, Wood E, et al. Continued improvement in survival among HIV-infected individuals with newer forms of highly active antiretroviral therapy. AIDS. 2007;21(6):685–692.
Authors :  12
Identifiers
Doi : 10.1097/QAD.0000000000001738
SSN : 1473-5571
Study Population
Men
Mesh Terms
Adolescent
Other Terms
Study Design
Study Approach
Country of Study
Kenya
Publication Country
England