Health-Related Quality of Life Outcomes in HIV-Infected Patients Starting Different Combination Regimens in a Randomized Multinational Trial: The INITIO-QoL Substudy

Bucciardini, Raffaella; Fragola, Vincenzo; Massella, M; Polizzi, Cosimo; Mirra, M.; Goodall, Ruth; Carey, Dianne; Hudson, Fleur; Zajdenverg, Roberto; Floridia, Marco

doi:10.1089/aid.2007.0067

Cited by 16 publications

(10 citation statements)

References 12 publications

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“…A nested sub-study of the INITIO trial was done to see whether the HRQOL in asymptomatic HIV patients initiating HAART with NRTIs (didanosine + stavudine) and efavirenz or nelfinavir or both were significantly different [122]. The MOS-HIV scale was used in the study to measure HRQOL with results grouped in PHS and MHS.…”

Section: Hrqol With Specific Art Regimensmentioning

confidence: 99%

Health-related Quality of Life Assessment after Antiretroviral Therapy: A Review of the Literature

Gakhar

Kamali

Holodniy

2013

Drugs

119

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Antiretroviral (ARV) treatment for HIV infection has resulted in significant improvement in immunologic and virologic parameters, as well as a reduction in AIDS-defining illnesses and death. Over 25 medications are approved for use, usually in combination regimens of three or four ARVs. Several ARVs are now available as combinatorial products, which have been associated with better adherence. However, while ARV therapy has prolonged life, ARVs also pose a challenge for quality of life as they can cause significant side effects in addition to the potential for drug toxicity and interaction. Given the many complications, side effects and symptoms of HIV/AIDS in addition to associated medical and psychiatric co-morbidities, the need to understand and assess how these interactions may affect health-related quality of life (HRQOL) has grown. Numerous instruments (some validated, others not) are available and have been applied to understanding how ARV treatment affects HRQOL in those with HIV infection, both in clinical trials and clinical practice. In general, ARV treatment improves HRQOL, but this is dependent on the population being studied, the HRQOL instrument being used and the timeframe during which HRQOL has been studied. This article provides a review of the literature on quality of-life assessment as it relates to ARV treatment in developed countries and briefly reviews the HRQOL instruments used, how they have been applied to ARV utilization, and where future research should be applied in HRQOL assessment and HIV infection.

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Section: Hrqol With Specific Art Regimensmentioning

confidence: 99%

Health-related Quality of Life Assessment after Antiretroviral Therapy: A Review of the Literature

Gakhar

Kamali

Holodniy

2013

Drugs

119

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“…152 In the randomized INITO trial, efavirenz-based or nelfinavir-based therapy improved physical and mental health scores during 3 year follow-up. 153 In the VESD study over two-thirds of patients receiving once-daily efavirenz/didanosine/lamivudine considered their quality of life ‘good’ or ‘very good’ at 6 and 12 months. 154 In the AI266073 study, patients who switched to a single-dose efavirenz/emtricitabine/tenofovir treatment reported improvements in HIV-related symptoms such as diarrhoea, bloating, pain, gas, change in the way their body looked and problems having sex, although they also experienced transient worsening of CNS symptoms at week 4.…”

Section: Quality Of Lifementioning

confidence: 99%

Efavirenz: a decade of clinical experience in the treatment of HIV

Maggiolo¹

2009

Journal of Antimicrobial Chemotherapy

108

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Efavirenz, a non-nucleoside reverse transcriptase inhibitor, has been an important component of the treatment of HIV infection for 10 years and has contributed significantly to the evolution of highly active antiretroviral therapy (HAART). The efficacy of efavirenz has been established in numerous randomized trials and observational studies in HAART-naive patients, including those with advanced infection. In the ACTG A5142 study, efavirenz showed greater virological efficacy than the boosted protease inhibitor (PI), lopinavir. Efavirenz is more effective as a third agent than unboosted PIs or the nucleoside analogue abacavir. Some, but not all, studies have suggested that efavirenz (added to two nucleoside reverse transcriptase inhibitors) is more effective than nevirapine. Virological and immunological responses achieved with efavirenz-based HAART have been maintained for 7 years. Dosing convenience predicts adherence, and studies have demonstrated that patients can be switched from PI-based therapy to simplified, once-daily efavirenz-based regimens without losing virological control. The one-pill, once-daily formulation of efavirenz plus tenofovir and emtricitabine offers a particular advantage in this regard. Efavirenz also retains a role after failure of a first PI-based regimen. Efavirenz is generally well tolerated: rash and neuropsychiatric disturbances are the most notable adverse events. Neuropsychiatric disturbances generally develop early in treatment and they tend to resolve with continued administration, but they are persistent and troubling in a minority of patients. Efavirenz has less effect on plasma lipid profiles than some boosted PIs. Lipodystrophy can occur under treatment with efavirenz but it may be reduced if the concurrent use of thymidine analogues is avoided. Efavirenz resistance mutations (especially K103N) can be selected during long-term treatment, underscoring the importance of good adherence. Recent data have confirmed that efavirenz is a cost-effective option for first-line HAART. In light of these features, efavirenz retains a key role in HIV treatment strategies and is the first-line agent recommended in some guidelines.

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“…6 Mental and physical HRQOL decrease with more advanced stages of HIV disease 5, 6 and with an increasing number of HIV symptoms. 9, 10 While HRQOL may improve with treatment of HIV infection and symptoms, 9, 11–13 HIV-infected patients with low HRQOL experience decreased survival. 14–16 Improvements in the HRQOL of HIV-infected persons increase survival.…”

Section: Introductionmentioning

confidence: 99%

Improved Quality of Life for Opioid-Dependent Patients Receiving Buprenorphine Treatment in HIV Clinics

Korthuis

Tozzi

Nandi

et al. 2011

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background Opioid dependence and HIV infection are associated with poor health-related quality of life (HRQOL). Buprenorphine/naloxone (bup/nx) provided in HIV care settings may improve HRQOL. Methods We surveyed 289 HIV-infected opioid-dependent persons treated with clinic-based bup/nx about HRQOL using the Short Form Health Survey (SF-12) administered at baseline, 3, 6, 9, and 12 months. We used normalized SF-12 scores which correspond to a mean HRQOL of 50 for the general U.S. population (SD 10, possible range 0–100). We compared mean normalized mental and physical composite and component scores in quarters 1, 2, 3, and 4 with baseline scores using GEE models. We assessed the effect of clinic-based bup/nx prescription on HRQOL composite scores using mixed effects regression with site as random effect and time as repeated effect. Results Baseline normalized SF-12 scores were lower than the general U.S. population for all HRQOL domains. Average composite mental HRQOL improved from 38.3 (SE 12.5) to 43.4 (SE 13.2) (β 1.13 [95% CI 0.72, 1.54]) and composite physical HRQOL remained unchanged (β 0.21 [95% CI −0.16, 0.57]) over 12 months follow-up. Continued bup/nx treatment across all four quarters was associated with improvements in both physical (β 2.38 [95% CI 0.63, 4.12]) and mental (β 2.51 [95% CI 0.42, 4.60]) HRQOL after adjusting for other contributors to HRQOL. Conclusions Clinic-based bup/nx maintenance therapy is potentially effective in ameliorating some of the adverse effects of opioid dependence on HRQOL for HIV-infected populations.

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Health-Related Quality of Life Outcomes in HIV-Infected Patients Starting Different Combination Regimens in a Randomized Multinational Trial: The INITIO-QoL Substudy

Cited by 16 publications

References 12 publications

Health-related Quality of Life Assessment after Antiretroviral Therapy: A Review of the Literature

Health-related Quality of Life Assessment after Antiretroviral Therapy: A Review of the Literature

Efavirenz: a decade of clinical experience in the treatment of HIV

Improved Quality of Life for Opioid-Dependent Patients Receiving Buprenorphine Treatment in HIV Clinics

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