Highly active antiretroviral treatment and health related quality of life in South African adults with human immunodeficiency virus infection: A cross-sectional analytical study

Abstract

BackgroundHealth Related Quality of Life (HRQoL) is an important outcome in times of Highly Active Antiretroviral Treatment (HAART). We compared the HRQoL of HIV positive patients receiving HAART with those awaiting treatment in public sector facilities in the Free State province in South Africa.MethodsA stratified random sample of 371 patients receiving or awaiting HAART were interviewed and the EuroQol-profile, EuroQol-index and Visual Analogue Scale (VAS) were compared. Independent associations between these outcomes and HAART, socio-demographic, clinical and health service variables were estimated using linear and ordinal logistic regression, adjusted for intra-clinic clustering of outcomes.ResultsPatients receiving HAART reported better HRQoL for 3 of the 5 EuroQol-dimensions, for the VAS score and for the EuroQol index in bivariable analysis. They had a higher mean EuroQol index (0.11 difference, 95% confidence interval [CI] 0.04; 0.23), and were more likely to have a higher index (odds ratio 1.9, 95% CI 1.1; 1.3), compared to those awaiting HAART, in multivariate analysis. Higher mean VAS scores were reported for patients who were receiving HAART (6.5 difference, 95% CI 1.3; 11.7), were employed (9.1, 95% CI 4.3; 13.7) or were female (4.7, 95% CI 0.79; 8.5).ConclusionHAART was associated with improved HRQoL in patients enrolled in a public sector treatment program in South Africa. Our finding that the EuroQol instrument was sensitive to HAART supports its use in future evaluation of HIV/AIDS care in South Africa. Longitudinal studies are needed to evaluate changes in individuals' HRQoL.

HIV Symptoms and Health-Related Quality of Life Prior to Initiation of HAART in a Sample of HIV-Positive South Africans

“…The variety of HRQoL instruments available reflects the lack of consensus on the number of items which should be included and how the construct of HRQoL should be measured (Robinson 2004). Only a handful of studies have looked at the QoL of PLHIV in southern Africa (Hughes et al 2004;Jelsma et al 2005;Louwagie et al 2007;Peltzer and PhaswanaMafuya 2008b;Phaladze et al 2005;Wouters et al 2007). These study populations had low CD4 counts and were either about to initiate HAART or had commenced HA-ART.…”

Health related quality of life of survivors of trauma six months after discharge

“…In the South African population, the EQ 5D has been used in measuring the HRQOL in non ICU populations (Jelsma et al 2004;Jelsma et al 2005;Louwagie et al 2007); no evidence of its use in the assessment of HRQOL of the South African ICU population could be found. The SF 36 has been used to assess HRQOL in some non ICU popu lations in South Africa (Benitha and Tikly 2007;O'Keefe and Wood 1996).…”

A Comparative Study of Health Related-Quality of Life Among HIV Patients on Pre-HAART and HAART in Uyo South-South Nigeria

“…A study in Uganda showed significant improvement in HR QOL at the third month of therapy [28,33]. In South Africa, patients on HAART showed improvement in three of the five domains of the Euro-Qol 5D instrument, when compared to patients awaiting HAART [34]. At the end of the four month the HR QOL of both HAART and Pre HAART became similar, while factors like marital status and clinical stage at presentation were significantly associated with the overall HRQOL of the patients, socio demographic characteristics like age and sex showed no relationship.…”