Relationship between CD4 count and quality of life over time among HIV patients in Uganda: a cohort study.

Journal: Health and quality of life outcomes

Volume: 13

Issue: 

Year of Publication: 2016

Affiliated Institutions:  Department of Medicine, Makerere College of Health Sciences, PO Box , Kampala, Uganda. dorismutabazi@yahoo.com. Department of Psychology, University of Bath, Bath, United Kingdom. psmfm@bath.ac.uk. MRC/UVRI Uganda Research Unit on AIDS, Uganda Virus Research Institute, Entebbe, Uganda. janet.seeley@mrcuganda.org. Department of Medicine, Makerere College of Health Sciences, PO Box , Kampala, Uganda. akatamba@yahoo.com.

Abstract summary 

Immunological markers (CD4 count) are used in developing countries to decide on initiation of antiretroviral therapy and monitor HIV/AIDS disease progression. HIV is an incurable chronic illness, making quality of life paramount. The direct relationship between quality of life and CD4 count is unclear. The purpose of this study is to determine the relationship between change in CD4 count and quality of life measures in a Ugandan cohort of people living with HIV.We prospectively assessed quality of life among 1274 HIV patients attending an HIV clinic within a national referral hospital over a period of 6 months. Quality of life was measured using an objective measure, the Medical Outcomes Study HIV health survey summarized as Physical Health Score and Mental Health Score and a subjective measure, the Global Person Generated Index. Generalized estimating equations were used to analyze the data. The primary predictor variable was change in CD4 count, and the outcome was quality of life scores. We controlled for sociodemographic characteristics, clinical factors and behavioral factors. Twenty in-depth interviews were conducted to assess patient perception of quality of life and factors influencing quality of life.Of the 1274 patients enrolled 1159 had CD4 count at baseline and six months and 586 (51%) received antiretroviral therapy. There was no association found between change in CD4 count and quality of life scores at univariate and multivariate analysis among the study participants whether on or not on antiretroviral therapy. Participants perceived quality of life as happiness and well-being, influenced by economic status, psychosocial factors, and health status.Clinicians and policy makers cannot rely on change in immunological markers to predict quality of life in this era of initiating antiretroviral therapy among relatively healthy patients. In addition to monitoring immunological markers, socioeconomic and psychosocial factors should be underscored in management of HIV patients.

Authors & Co-authors:  Mwesigire Doris Mutabazi DM Martin Faith F Seeley Janet J Katamba Achilles A

Study Outcome 

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Statistics
Citations :  Mellors JW, Munoz A, Giorgi JV, Margolick JB, Tassoni CJ, Gupta P, et al. Plasma Viral Load and CD4+ Lymphocytes as Prognostic Markers of HIV-1 Infection. Ann Intern Med. 1997;126(12):946–54. doi: 10.7326/0003-4819-126-12-199706150-00003.
Authors :  4
Identifiers
Doi : 144
SSN : 1477-7525
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
England