Differences in normal activities, job performance and symptom prevalence between patients not yet on antiretroviral therapy and patients initiating therapy in South Africa

Rosen, Sydney; Ketlhapile, Mpefe; Sanne, Ian; DeSilva, Mary Bachman

doi:10.1097/01.aids.0000327634.92844.91

Cited by 39 publications

(42 citation statements)

References 10 publications

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“…One approach in evaluating the balance between the potential positive and adverse consequences of treatment is to monitor the quality of life (QoL) of people living with HIV/AIDS, who are receiving treatment (Jelsma, Maclean, Hughes, Tinise, & Darder, 2005;Park-Wyllie et al, 2007;Rosen, Ketlhapile, Sanne, & Bachman DeSilva, 2008). Improvements in their functional status and well-being can be considered essential determinants of the balance between the clinical benefits and potential adverse effects.…”

Section: Introductionmentioning

confidence: 99%

State of the ART: clinical efficacy and improved quality of life in the public antiretroviral therapy program, Free State province, South Africa

et al. 2009

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The South African public-sector antiretroviral treatment (ART) program has yielded promising early results. To extend and reinforce these preliminary findings, we undertook a detailed assessment of the clinical efficacy and outcomes over two years of ART. The primary objective was to assess the clinical outcomes and adverse effects of two years of ART, while identifying the possible effects of baseline health and patient characteristics. A secondary objective was to address the interplay between positive and negative outcomes (clinical benefits versus adverse effects) in terms of the patients' physical and emotional quality of life (QoL). Clinical outcome, baseline characteristics, health status, and physical and emotional QoL scores were determined from clinical files and interviews with 268 patients enrolled in the Free State ART program at three time points (6, 12, and 24 months of ART). Age, sex, education, and baseline health (CD4 cell count and viral load) were all independently associated with the ART outcome in the early stages of treatment, but their impact diminished as the treatment progressed. The number of patients classified as treatment successes increased over the first two years of ART, whereas the proportion of patients experiencing adverse effects diminished. Importantly, our findings show that ART had strong and stable positive effects on physical and emotional QoL. These favorable results demonstrate that a well-managed public-sector ART program can be very successful within a high-HIV-prevalence resource-limited setting. This finding emphasizes the need to adopt treatment scale-up as a key policy priority, while at the same time ensuring that the highest standards of healthcare provision are maintained. Healthcare services should also target vulnerable groups (males, less-educated patients, those with low baseline CD4 cell counts, and high baseline viral loads) who are most likely to experience treatment failure.

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Section: Introductionmentioning

confidence: 99%

State of the ART: clinical efficacy and improved quality of life in the public antiretroviral therapy program, Free State province, South Africa

et al. 2009

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“…Existing literature reports a prevalence of activity limitation of 9% [23] among Canadians living with HIV/AIDS, and a range between 32 and 52% among HIV/ AIDS patients reporting some limitation in either their home or work life in South Africa [5].…”

Section: Discussionmentioning

confidence: 99%

“…Existing research from Kenya and South Africa suggests that individuals on HAART have lower rates of job absenteeism, and are significantly less likely to report being functionally impaired (such as unable to go to work, seek employment, or do housework) compared to those not on HAART [5,6]. However, as the official unemployment rates can be as high as 25% in parts of South Africa, job absenteeism is not an ideal measure of functional well being.…”

Section: Introductionmentioning

confidence: 99%

“…However, as the official unemployment rates can be as high as 25% in parts of South Africa, job absenteeism is not an ideal measure of functional well being. Instead, a person's ability to perform instrumental activities of daily living (IADL) might be more sensitive and may generate additional insights into the contribution of HAART to functional well-being [5]. Currently only a small selection of articles from Africa have investigated the functional benefits derived from improved access to HAART.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Highly Active Antiretroviral Therapy on Activities of Daily Living in HIV-Infected Adults in South Africa

et al. 2010

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This study investigated the relationship between highly active antiretroviral therapy (HAART) and instrumental activities of daily living (IADLs) among two clinical cohorts in South Africa. Between 2003 and 2008 structured questionnaires were administered to HIV-positive patients attending outpatient clinics at an urban hospital (Soweto, n = 3,081) and a rural hospital (Acornhoek, n = 1,247). Among those receiving help, an average of 4.8 and 5.1 h of assistance with IADLs daily was reported (rural and urban participants, respectively), with the patient's mother and children assisting the most. Participants on HAART were 17 and 41% less likely to receive assistance with IADLs in the rural and urban cohorts, respectively, after adjusting for demographic characteristics, healthcare utilization, and CD4 counts. HAART significantly decreased the IADL assistance among patients in South Africa. Alongside clinical benefits, HAART has the potential to reduce the burden of HIV-related care, potentially extending wider social and economic gains to other family members.

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“…Morbidity in women who are HIV-positive may impact their quality of life and ability to care for themselves and their families (Crystal & Sambamoorthi, 1996;Rosen et al, 2008; Bignami-Van Assche, Assche, Anglewicz, & van de Ruit, 2011;Thirumurthy et al, 2011;Biraguma & Rhoda, 2012). Morbidity in women who are HIV-positive and drug-naïve has not been well described.…”

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confidence: 99%

Morbidity and nutrition status of rural drug-naïve Kenyan women living with HIV

Neumann

Nyandiko

Siika

et al. 2016

African Journal of AIDS Research

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Differences in normal activities, job performance and symptom prevalence between patients not yet on antiretroviral therapy and patients initiating therapy in South Africa

Abstract: Patients who have initiated ART reported significantly less functional impairment, fewer symptoms, and better work performance than those who had not yet started treatment. The prevalence of some impairment, symptoms, and absenteeism remained high, however.

Cited by 39 publications

References 10 publications

State of the ART: clinical efficacy and improved quality of life in the public antiretroviral therapy program, Free State province, South Africa

State of the ART: clinical efficacy and improved quality of life in the public antiretroviral therapy program, Free State province, South Africa

The Impact of Highly Active Antiretroviral Therapy on Activities of Daily Living in HIV-Infected Adults in South Africa

Morbidity and nutrition status of rural drug-naïve Kenyan women living with HIV

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