The associations among coping, nadir CD4+ T-cell count, and non-HIV-related variables with health-related quality of life among an ambulatory HIV-positive patient population
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We investigated HRQoL among HIV-positive outpatients from October, 2006-December, 2007, incorporating medical chart review, and a survey of coping styles.
Consented HIV-positive patients receiving medical care at University of Colorado Denver, with HAART as first antiretroviral regimen, completed the MOS-HIV and Brief COPE survey instruments. Linear regression identified a priori factors hypothesized to be associated with the MOS-HIV composite mental and physical health scores (MHS, PHS). Brief COPE survey maladaptive and adaptive coping components were added to the models and retained if significant.
Among the 157 patient cohort, parsimonious multivariable linear regression models (P < 0.05) indicated higher nadir CD4+ T-cell counts and adaptive coping were associated with a higher MHS; public/no insurance, mental illness, current number of non-HIV medications, and maladaptive coping were inversely associated with MHS. Nadir CD4+ T-cell count and efavirenz use were associated with a higher PHS; mental illness, current number of non-HIV mediations, and maladaptive coping were inversely associated with PHS.
Factors independently associated with lower MHS and lower PHS include lower nadir CD4+ T-cell counts, and use of maladaptive coping. Efforts to reduce use of maladaptive coping strategies and earlier identification and treatment of HIV may improve HRQoL in HIV-positive patients.
KeywordsHIV Nadir CD4+ T-cell count Coping Quality of life
Acquired immunodeficiency syndrome
Highly active antiretroviral therapy
Human immunodeficiency virus
Health-related quality of life
Infectious disease group practice
Intravenous drug user
Mental health score
Medical outcomes study
Men who have sex with men
Nucleoside analog reverse transcriptase inhibitor
Non-nucleoside analog reverse transcriptase inhibitor
Physical health score
University of Colorado Health Sciences Center
University of Colorado Health Sciences Center Adult General Clinical Research Center National Institutes of Health grant MO1 #RR00051 provided funding for patient participation honoraria.
Conflicts of interest
Dr. Armon has no conflicts of interest. Dr. Lichtenstein receives research support from Merck, Pfizer, and TaiMed. He serves on advisory boards for Abbott, Merck, Bristol-Myers Squibb, Gilead, and Tibotec.
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