Impact of Antiretroviral Therapy on Health-Related Quality of Life among South African Women in the CAPRISA 002 Acute Infection Study

Abstract

Concerns are often raised regarding potentially adverse effects of antiretroviral therapy (ART) on health-related quality of life (HRQoL), but there is limited longitudinal data to prove this. Building on our prior investigation, we examined the impact of ART on HRQoL among HIV-infected South African women with extensive follow-up in the CAPRISA 002 Acute Infection Cohort Study. Overall HRQoL and five sub-domains [physical well-being (PWB), emotional well-being (EWB), functional and global well-being (FGWB), social well-being (SWB) and cognitive functioning (CF)] were assessed using the Functional Assessment of HIV Infection (FAHI) instrument. Our analyses comparing FAHI scores between pre-ART (established infection) and ART phases using paired Wilcoxon signed-rank tests and adjusted mixed-effects regression models revealed improvements on ART in overall HRQoL, and in PWB, EWB, and SWB, but not in FGWB and CF. No long-term adverse impact of ART on HRQoL was detected, providing additional non-biomedical support to early treatment strategies.

A mixed methods approach to adapting and evaluating the functional assessment of HIV infection (FAHI), Swahili version, for use with low literacy populations

“…Additionally, our factor analysis indicates that the items had good factor loadings of 0.600, 0.543 and 0.495, an indication that they are interrelated. Moreover, our findings are consistent with earlier studies which generally reported internal consistency scores for FAHI above the acceptable cut-offs with the CF subscale usually having the lowest alpha coefficient [30–32]. …”

“…Seven out of the 16 reviewed studies reported psychometric properties. The internal consistency of the total scale in these studies was invariably excellent (Cronbach’s α range 0.91–0.92) [17, 22, 30–32]. The subscale α coefficients ranged from 0.72–0.92 with the exception of the cognitive function (CF) domain in two studies from South Africa whose α coefficients were slightly below the recommended 0.70 (Cronbach’s α values of 0.65 and 0.60) [13, 17, 22, 30–33].…”

Association among oral symptoms, oral health-related quality of life, and health-related quality of life in a sample of adults living with HIV/AIDS in Malaysia

“…There is limited evidence, particularly from prospective studies, about the benefits of HAART on HRQOL. Some studies showed significant overall improvement under HAART [ 48 , 49 ], some showed only modest improvement [ 50 , 51 ], and others raised concerns about deterioration of physical health after long-term HAART [ 52 ]. A large multicentre prospective cohort study in the United States demonstrated that HAART was associated with significant short-term improvements in HRQOL, but continued use of HAART did not lead to further changes, in that HRQOL remained declined slightly at a subsequent follow-up [ 53 ].…”

Interventions targeting sexual and reproductive health and rights outcomes of young people living with HIV: a comprehensive review of current interventions from sub-Saharan Africa

“…Medically, adherence to ART is required to decrease opportunistic infections and to ensure virological suppression ( 3 ). Improved overall health substantially affects overall well-being, including SRH ( 27 ). In addition, access and adherence to ART is also critical for safer conception ( 28 ).…”