, Volume 73, Issue 7, pp 651–672 | Cite as

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

  • Harleen Gakhar
  • Amanda Kamali
  • Mark HolodniyEmail author
Review Article


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.


Human Immunodeficiency Virus Human Immunodeficiency Virus Infection Efavirenz Atazanavir Lipodystrophy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



All authors report no conflicts of interest relevant to this article. This study was funded by intramural funds from the Department of Veterans Affairs. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Departments of Veterans Affairs or the United States Government.


  1. 1.
    UNAIDS. Report on the global AIDS epidemic, 2010. Joint United Nations Programme on HIV/AIDS and World Health Organization; 2010.Google Scholar
  2. 2.
    Centers for Disease Control and Prevention. HIV incidence. (Accessed 25 Oct 2012).
  3. 3.
    Centers for Disease Control and Prevention. Health Related Quality of Life (HRQOL). (Accessed 25 Jan 2013).
  4. 4.
    Grossman HA, Sullivan PS, Wu AW. Quality of life and HIV: current assessment tools and future directions for clinical practice. AIDS Read. 2003;13(12):583–90, 595–7.Google Scholar
  5. 5.
    Lin MK, Wu AW, Revicki DA. Incorporating quality of life measures in HIV clinical trials. HIV Clin Trials. 2002;3(3):202–18.PubMedCrossRefGoogle Scholar
  6. 6.
    Shumaker SA, Ellis S, Naughton M. Assessing health-related quality of life in HIV disease: key measurement issues. Qual Life Res. 1997;6(6):475–80.PubMedCrossRefGoogle Scholar
  7. 7.
    Garvie PA, et al. Quality of life measurement in paediatric and adolescent populations with HIV: a review of the literature. Child Care Health Dev. 2009;35(4):440–53.PubMedCrossRefGoogle Scholar
  8. 8.
    Tavakol M, Dennick R. Making sense of Cronbach’s alpha. Int J Med Educ. 2011;2:53–5.CrossRefGoogle Scholar
  9. 9.
    Franchi D, Wenzel RP. Measuring health-related quality of life among patients infected with human immunodeficiency virus. Clin Infect Dis. 1998;26(1):20–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Li AWP. Dictionary of evidence base medicine. Oxon: Radcliffe Medical Press Ltd; 1998.Google Scholar
  11. 11.
    Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Lawrence Erlbaum Associates, Inc.; 1988.Google Scholar
  12. 12.
    Clayson DJ, et al. A comparative review of health-related quality-of-life measures for use in HIV/AIDS clinical trials. Pharmacoeconomics. 2006;24(8):751–65.PubMedCrossRefGoogle Scholar
  13. 13.
    Tsasis P. Health-related quality-of-life measurements in HIV/AIDS care. AIDS Patient Care STDS. 2000;14(8):427–38.PubMedCrossRefGoogle Scholar
  14. 14.
    de Boer JB, van Dam FS, Sprangers MA. Health-related quality-of-life evaluation in HIV-infected patients. A review of the literature. Pharmacoeconomics. 1995;8(4):291–304.PubMedCrossRefGoogle Scholar
  15. 15.
    Hays RD, Shapiro MF. An overview of generic health-related quality of life measures for HIV research. Qual Life Res. 1992;1(2):91–7.PubMedCrossRefGoogle Scholar
  16. 16.
    Robinson FP. Measurement of quality of life in HIV disease. J Assoc Nurses AIDS Care. 2004;15(5 Suppl):14S–9S.PubMedCrossRefGoogle Scholar
  17. 17.
    Stewart AL, Ware JE. Measuring functioning and well-being: the medical outcomes study approach. Durham: Duke University Press; 1992.Google Scholar
  18. 18. The SF-8 Health Survey. (Accessed 25 Jan 2013).
  19. 19.
    Kaplan RM, Bush JW, Berry CC. The reliability, stability, and generalizability of a health status index from the Proceedings of the American Statistical Association. Washington, DC: American Statistical Association; 1978.Google Scholar
  20. 20.
    Hunt SM, et al. The Nottingham health profile: subjective health status and medical consultations. Soc Sci Med. 1981;15A:221–9.Google Scholar
  21. 21.
    Vanhems P, Toma E, Pineault R. Quality of life assessment and HIV infection: a review. Eur J Epidemiol. 1996;12(3):221–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Bergner M, et al. The sickness impact profile: development and final revision of a health status measure. Med Care. 1981;19(8):787–805.PubMedCrossRefGoogle Scholar
  23. 23.
    Rabin R, de Charro F. EQ5D: a measure of health status from the EuroQol Group. Ann Med. 2011;33(5):227–43.Google Scholar
  24. 24.
    Anis AH, et al. Quality of life of patients with advanced HIV/AIDS: measuring the impact of both AIDS-defining events and non-AIDS serious adverse events. J Acquir Immune Defic Syndr. 2009;51(5):631–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Torrance GW, et al. Multi-attribute preference function: Health Utilities Index. Pharmacoeconomics. 1995;7:490–502.PubMedCrossRefGoogle Scholar
  26. 26.
    Horsman J, Furlong W, Feeny D. The Health Utilities Index (HUI): concepts, measurement properties and applications. Health Qual Life Outcomes. 2003;1:54.PubMedCrossRefGoogle Scholar
  27. 27.
    Torrance GW, Thomas WH, Sackett DL. A utility maximization model for evaluation of health care programs. Health Serv Res. 1972;7:113–8.Google Scholar
  28. 28.
    von Neumann J, Morgenstein O. Theory of games and economic behavior. New York: Wiley; 1953.Google Scholar
  29. 29.
    Torrance GW. Social preferences for health states: an empirical evaluation of three measurements. Socio Econ Plan Sci. 1976;10:129–36.CrossRefGoogle Scholar
  30. 30.
    World Health Organization. WHOQoL Study Protocol. WHO (MNH7PSF/93.9); 1993. (Accessed 22 Feb 2013).
  31. 31.
    World Health Organization Quality of Life Instrument Group. Initial steps to developing the World Health Organization’s Quality of Life Instrument (WHOQOL) module for international assessment in HIV/AIDS. AIDS Care. 2003;15(3):347–57.CrossRefGoogle Scholar
  32. 32.
    Schag CA, et al. Assessing the needs and quality of life of patients with HIV infection: development of the HIV Overview of Problems-Evaluation System (HOPES). Qual Life Res. 1992;1(6):397–413.PubMedCrossRefGoogle Scholar
  33. 33.
    Lenderking WR, et al. Measuring quality of life in early HIV disease: the modular approach. Qual Life Res. 1997;6(6):515–30.PubMedCrossRefGoogle Scholar
  34. 34.
    Cleary PD, et al. Health-related quality of life in persons with acquired immune deficiency syndrome. Med Care. 1993;31(7):569–80.PubMedCrossRefGoogle Scholar
  35. 35.
    Burgess A, et al. The reliability and validity of two HIV-specific health-related Quality-of-Life measures: a preliminary analysis. AIDS. 1993;7(7):1001–8.PubMedCrossRefGoogle Scholar
  36. 36.
    Jette AM, Davies AR, Cleary PD. The Functional Status Questionnaire: its reliability and validity when used in primary care. J Gen Intern Med. 1986;1:143–9.PubMedCrossRefGoogle Scholar
  37. 37.
    Statistic NCfH. National Health Interview Survey, 1986. Interviewer’s Manual, HIS. Hyattsville: National Center for Health Statistics; 1986.Google Scholar
  38. 38.
    Winterling D, et al. A self-rating scale for assessing memory loss. Bethesda: Memory Assessment Clinics Inc; 1986.Google Scholar
  39. 39.
    Cella DF, et al. Development and validation of the Functional Assessment of Human Immunodeficiency Virus Infection (FAHI) quality of life instrument. Qual Life Res. 1996;5(4):450–63.PubMedCrossRefGoogle Scholar
  40. 40.
    Holmes WC, Shea JA. Two approaches to measuring quality of life in HIV/AIDS population: HAT-QOL and MOS-HIV. Qual Life Res. 1999;8:515–27.PubMedCrossRefGoogle Scholar
  41. 41.
    Avis NE, Smith KW. Development of the MQOL-HIV: the Multidimensional Quality of Life questionnaire for persons with HIV/AIDS. Qual Life Newslett. 1997;17:3–4.Google Scholar
  42. 42.
    Bozzette SA, et al. Derivation and properties of a brief health status assessment instrument for use in HIV disease. J Acquir Immune Defic Syndr Hum Retrovirol. 1995;8(3):253–65.PubMedCrossRefGoogle Scholar
  43. 43.
    Coplan PM, et al. Impact of indinavir on the quality of life in patients with advanced HIV infection treated with zidovudine and lamivudine. Clin Infect Dis. 2004;39(3):426–33.PubMedCrossRefGoogle Scholar
  44. 44.
    Wu AW, et al. Creating a crosswalk to estimate AIDS Clinical Trials Group quality of life scores in a nationally representative sample of persons in care for HIV in the United States. HIV Clin Trials. 2005;6(3):147–57.PubMedCrossRefGoogle Scholar
  45. 45.
    Wu AW, et al. Applications of the Medical Outcomes Study health-related quality of life measures in HIV/AIDS. Qual Life Res. 1997;6(6):531–54.PubMedCrossRefGoogle Scholar
  46. 46.
    Wu AW, et al. Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Qual Life Res. 1997;6(6):481–93.PubMedCrossRefGoogle Scholar
  47. 47.
    Wu AW, et al. A health status questionnaire using 30 items from the Medical Outcomes Study. Med Care. 1991;29:786–98.PubMedCrossRefGoogle Scholar
  48. 48.
    Justice AC, Adult AIDS Clinical Trials Unit Outcomes Committee, et al. Development and validation of a self-completed HIV symptom index. J Clin Epidemiol. 2001;54(suppl 1):S77–90.PubMedCrossRefGoogle Scholar
  49. 49.
    Sprinz E, et al. Substitution with lopinivir/ritonavir improves patient-reported outcomes including quality of life in patients who were intolerant to their antiretroviral therapy. HIV Clin Trials. 2006;7(6):291–308.PubMedCrossRefGoogle Scholar
  50. 50.
    Crane HM, et al. Routine collection of patient-reported outcomes in an HIV clinic setting: the first 100 patients. Curr HIV Res. 2007;5(1):109–18.PubMedCrossRefGoogle Scholar
  51. 51.
    Crane HM, et al. A single-item measure of health-related quality of life for HIV-infected patients in routine clinical care. AIDS Patient Care STDS. 2006;20(3):161–74.PubMedCrossRefGoogle Scholar
  52. 52.
    US Department of Health and Human Services. Guidance for industry patient reported outcome measures: use in medical product development to support labeling claims. US Dept of Health and Human Services, Center for Drug Evaluation and Research (CDER); 2009.Google Scholar
  53. 53.
    Duracinsky M, et al. The development of PROQOL-HIV: an international instrument to assess the health-related quality of life of persons living with HIV/AIDS. JAIDS. 2012;59:498–505.PubMedCrossRefGoogle Scholar
  54. 54.
    Spire B, et al. Simplification and first validation of a short battery of patient questionnaires for clinical management of HIV-infected patients: The HIV-SQUAD (Symptom Quality of life Adherence) Questionnaire. HIV Clin Trials. 2009;10(4):215–32.PubMedCrossRefGoogle Scholar
  55. 55.
    Bucciardini R, et al. ISSQoL: a new questionnaire for evaluating the quality of life of people living with HIV in the HAART era. Qual Life Res. 2006;15(3):377–90.PubMedCrossRefGoogle Scholar
  56. 56.
    Aversa S, Kimberlin C, Segal R. The Medication Attribution Scale: perceived effects of antiretrovirals and quality of life. Qual Life Res. 1998;7(3):205–14.PubMedCrossRefGoogle Scholar
  57. 57.
    Stewart A, Hayes RD, Ware JE. The MOS short-form general health survey: reliability and validity in a patient population. Med Care. 1998;26:724–35.CrossRefGoogle Scholar
  58. 58.
    Stewart AL, Greenfield S, Hayes RD. Functional status and well being of patients with chronic conditions. J Am Med Assoc. 1989;262:907–13.CrossRefGoogle Scholar
  59. 59.
    Copfer AE, et al. The use of two measures of health-related quality of life in HIV-infected individuals: a cross-sectional comparison. Qual Life Res. 1996;5(2):281–6.PubMedCrossRefGoogle Scholar
  60. 60.
    Hughes TE, et al. Construct validities of the Quality of Well-Being Scale and the MOS-HIV-34 Health Survey for HIV-infected patients. Med Decis Making. 1997;17(4):439–46.PubMedCrossRefGoogle Scholar
  61. 61.
    Williams JB, Rabkin JG. The concurrent validity of items in the Quality-of-Life Index in a cohort of HIV-positive and HIV-negative gay men. Control Clin Trials. 1991;12(4 Suppl):129S–41S.PubMedCrossRefGoogle Scholar
  62. 62.
    Cella D, et al. Spanish language translation and initial validation of the functional assessment of cancer therapy quality-of-life instrument. Med Care. 1998;36(9):1407–18.PubMedCrossRefGoogle Scholar
  63. 63.
    Delate T, Coons SJ. The use of 2 health-related quality-of-life measures in a sample of persons infected with human immunodeficiency virus. Clin Infect Dis. 2001;32(3):E47–52.PubMedCrossRefGoogle Scholar
  64. 64.
    Hsiung PC, et al. Comparison of WHOQOL-bREF and SF-36 in patients with HIV infection. Qual Life Res. 2005;14(1):141–50.PubMedCrossRefGoogle Scholar
  65. 65.
    Nosyk B, et al. The concurrent validity and responsiveness of the health utilities index (HUI 3) among patients with advanced HIV/AIDS. Qual Life Res. 2009;18(7):815–24.PubMedCrossRefGoogle Scholar
  66. 66.
    Joyce VR, et al. Health-related quality of life in a randomized trial of antiretroviral therapy for advanced HIV disease. J Acquir Immune Defic Syndr. 2009;50(1):27–36.PubMedCrossRefGoogle Scholar
  67. 67.
    Carretero MD, et al. Reliability and validity of an HIV-specific health-related quality-of-life measure for use with injecting drug users. AIDS. 1996;10(14):1699–705.PubMedCrossRefGoogle Scholar
  68. 68.
    Henderson WA, et al. Validation of the MOS-HIV as a measure of health-related quality of life in persons living with HIV and liver disease. AIDS Care. 2010;22(4):483–90.PubMedCrossRefGoogle Scholar
  69. 69.
    Bolge SC, et al. The impact of anemia on quality of life and healthcare resource utilization in patients with HIV/AIDS receiving antiretroviral therapy. Curr Med Res Opin. 2007;23(4):803–10.PubMedCrossRefGoogle Scholar
  70. 70.
    Baum MK, et al. Quality of life, symptomatology and healthcare utilization in HIV/HCV co-infected drug users in Miami. J Addict Dis. 2008;27(2):37–48.PubMedCrossRefGoogle Scholar
  71. 71.
    Braitstein P, et al. Quality of life, depression and fatigue among persons co-infected with HIV and hepatitis C: outcomes from a population based-cohort. AIDS Care. 2005;17(4):505–15.PubMedCrossRefGoogle Scholar
  72. 72.
    Brongos Figuero LS, et al. Assessment of factors influencing health-related quality of life in HIV-infected patients. HIV Med. 2011;12(1):22–30.CrossRefGoogle Scholar
  73. 73.
    Briongos Figuero LS, et al. Depression and health related quality of life among HIV-infected people. Eur Rev Med Pharmacol Sci. 2011;15(8):855–62.PubMedGoogle Scholar
  74. 74.
    Diamond C, Taylor TH, Anton-Culver H. Quality of life, characteristics and survival of patients with HIV and lymphoma. Qual Life Res. 2010;19(2):149–55.PubMedCrossRefGoogle Scholar
  75. 75.
    Drummond MB, et al. HIV and COPD: impact of risk behaviors and disease on quality of life. Qual Life Res. 2010;19(9):1295–302.PubMedCrossRefGoogle Scholar
  76. 76.
    Fleming CA, et al. Health-related quality of life of patients with HIV disease: impact of hepatitis C coinfection. Clin Infect Dis. 2004;38(4):572–8.PubMedCrossRefGoogle Scholar
  77. 77.
    Badia X, et al. Evaluating changes in health status in HIV-infected patients: Medical Outcomes Study-HIV and Multidimensional Quality of Life-HIV quality of life questionnaires. Spanish MOS-HIV and MQOL-HIV Validation Group. AIDS. 2000;14(10):1439–47.PubMedCrossRefGoogle Scholar
  78. 78.
    Badia X, et al. A randomized study comparing instruments for measuring health-related quality of life in HIV-infected patients. Spanish MOS-HIV and MQOL-HIV Validation Group. Medical Outcomes Study HIV Health Survey. AIDS. 1999;13(13):1727–35.PubMedCrossRefGoogle Scholar
  79. 79.
    Paton NI, et al. Validation of the Medical Outcomes Study HIV Health Survey as a measure of quality of life in HIV-infected patients in Singapore. Int J STD AIDS. 2002;13(7):456–61.PubMedCrossRefGoogle Scholar
  80. 80.
    Stasinopoulou PG, et al. Reliability and validity of the Greek translation of the MOS-HIV health survey in HIV-infected individuals. Qual Life Res. 2010;19(2):199–205.PubMedCrossRefGoogle Scholar
  81. 81.
    Arpinelli F, et al. Health-related quality of life in asymptomatic patients with HIV. Evaluation of the SF-36 health survey in Italian patients. Pharmacoeconomics. 2000;18(1):63–72.PubMedCrossRefGoogle Scholar
  82. 82.
    Canavarro MC, et al. Quality of life assessment in HIV-infection: validation of the European Portuguese version of WHOQOL-HIV. AIDS Care. 2011;23(2):187–94.PubMedCrossRefGoogle Scholar
  83. 83.
    Chang CH, et al. The SF-36 physical and mental health factors were confirmed in cancer and HIV/AIDS patients. J Clin Epidemiol. 2007;60(1):68–72.PubMedCrossRefGoogle Scholar
  84. 84.
    Davis EA, Pathak DS. Psychometric evaluation of four HIV disease-specific quality-of-life instruments. Ann Pharmacother. 2001;35(5):546–52.PubMedCrossRefGoogle Scholar
  85. 85.
    Holmes WC, Ruocco JE. Test-retest evaluation of HAT-Qol and SF-36 in an HIV-seropositive sample. AIDS Care. 2008;20(9):1084–92.PubMedCrossRefGoogle Scholar
  86. 86.
    Holmes WC, Shea JA. Two approaches to measuring quality of life int he HIV/AIDS population: HAT-Qol and MOS-HIV. Qual Life Res. 1999;8(6):515–27.PubMedCrossRefGoogle Scholar
  87. 87.
    Stavem K, Froland SS, Hellum KB. Comparison of preference-based utilities of the 15D, EQ-5D and SF-6D in patients with HIV/AIDS. Qual Life Res. 2005;14(4):971–80.PubMedCrossRefGoogle Scholar
  88. 88.
    Bult JR, et al. Heterogeneity in the relationship between the time tradeoff and Short Form-36 for HIV-infected and primary care patients. Med Care. 1998;36(4):523–32.PubMedCrossRefGoogle Scholar
  89. 89.
    O’Leary JF, et al. Toward a better understanding of health-related quality of life: a comparison of the Medical Outcomes Study HIV Health Survey (MOS-HIV) and the HIV Overview of Problems-Evaluation System (HOPES). J Acquir Immune Defic Syndr Hum Retrovirol. 1998;17(5):433–41.PubMedCrossRefGoogle Scholar
  90. 90.
    Wu AW, et al. Validity and responsiveness of the euroqol as a measure of health-related quality of life in people enrolled in an AIDS clinical trial. Qual Life Res. 2002;11(3):273–82.PubMedCrossRefGoogle Scholar
  91. 91.
    Call SA, et al. Health-related quality of life and virologic outcomes in an HIV clinic. Qual Life Res. 2000;9(9):977–85.PubMedCrossRefGoogle Scholar
  92. 92.
    Cederfjall C, et al. Gender differences in perceived health-related quality of life among patients with HIV infection. AIDS Patient Care STDS. 2001;15(1):31–9.PubMedCrossRefGoogle Scholar
  93. 93.
    Cowdery JE, Pesa JA. Assessing quality of life in women living with HIV infection. AIDS Care. 2002;14(2):235–45.PubMedCrossRefGoogle Scholar
  94. 94.
    McDonnell KA, et al. Measuring health related quality of life among women living with HIV. Qual Life Res. 2000;9(8):931–40.PubMedCrossRefGoogle Scholar
  95. 95.
    Watanabe M, et al. A discriminative study of health-related quality of life assessment in HIV-1-infected persons living in Japan using the Multidimensional Quality of Life Questionnaire for persons with HIV/AIDS. Int J STD AIDS. 2004;15(2):107–15.PubMedCrossRefGoogle Scholar
  96. 96.
    Lorenz KA, et al. Changes in symptoms and health-related quality of life in a nationally representative sample of adults in treatment for HIV. Qual Life Res. 2006;15(6):951–8.PubMedCrossRefGoogle Scholar
  97. 97.
    Lorenz KA, et al. Associations of symptoms and health-related quality of life: findings from a national study of persons with HIV infection. Ann Intern Med. 2001;134(9 Pt 2):854–60.PubMedCrossRefGoogle Scholar
  98. 98.
    Lubeck DP, Fries JF. Changes in quality of life among persons with HIV infection. Qual Life Res. 1992;1(6):359–66.PubMedCrossRefGoogle Scholar
  99. 99.
    Bing EG, et al. Health-related quality of life among people with HIV disease: results from the Multicenter AIDS Cohort Study. Qual Life Res. 2000;9(1):55–63.PubMedCrossRefGoogle Scholar
  100. 100.
    Hays RD, et al. Health-related quality of life in patients with human immunodeficiency virus infection in the United States: results from the HIV Cost and Services Utilization Study. Am J Med. 2000;108(9):714–22.PubMedCrossRefGoogle Scholar
  101. 101.
    Miners AH, et al. Health-related quality of life in individuals infected with HIV in the era of HAART. HIV Clin Trials. 2001;2(6):484–92.PubMedCrossRefGoogle Scholar
  102. 102.
    Gill CJ, et al. Relationship of HIV viral loads, CD4 counts, and HAART use to health-related quality of life. J Acquir Immune Defic Syndr. 2002;30(5):485–92.PubMedCrossRefGoogle Scholar
  103. 103.
    Murri R, et al. Determinants of health-related quality of life in HIV-infected patients. AIDS Care. 2003;15(4):581–90.PubMedCrossRefGoogle Scholar
  104. 104.
    Weinfurt KP, et al. Relationship between CD4 count, viral burden, and quality of life over time in HIV-1-infected patients. Med Care. 2000;38(4):404–10.PubMedCrossRefGoogle Scholar
  105. 105.
    Mathews WC, May S. EuroQol (EQ-5D) measure of quality of life predicts mortality, emergency department utilization, and hospital discharge rates in HIV-infected adults under care. Health Qual Life Outcomes. 2007;5:5.PubMedCrossRefGoogle Scholar
  106. 106.
    Kudel I, et al. Patterns of responses on health-related quality of life questionnaires among patients with HIV/AIDS. J Gen Intern Med. 2006;21(Suppl 5):S48–55.PubMedCrossRefGoogle Scholar
  107. 107.
    Health and Human Services Panel on Antiretroviral Guidelines for Adults and Adolescents Panel Roster. Guidelines for the use of antiretroviral agents in HIV-1 infected adults and adolescents; 2013. (Accessed 25 Feb 2013).
  108. 108.
    Low-Beer S, et al. Health related quality of life among persons with HIV after the use of protease inhibitors. Qual Life Res. 2000;9(8):941–9.PubMedCrossRefGoogle Scholar
  109. 109.
    Carrieri P, et al. Health-related quality of life after 1 year of highly active antiretroviral therapy. J Acquir Immune Defic Syndr. 2003;32(1):38–47.PubMedCrossRefGoogle Scholar
  110. 110.
    Nieuwkerk PT, et al. Quality of life in asymptomatic- and symptomatic HIV infected patients in a trial of ritonavir/saquinavir therapy. The Prometheus Study Group. AIDS. 2000;14(2):181–7.PubMedCrossRefGoogle Scholar
  111. 111.
    Tramarin A, et al. A multicentre study of patient survival, disability, quality of life and cost of care: among patients with AIDS in northern Italy. Pharmacoeconomics. 2004;22(1):43–53.PubMedCrossRefGoogle Scholar
  112. 112.
    Protopopescu C, et al. Health-related quality of life in HIV-1-infected patients on HAART: a five-years longitudinal analysis accounting for dropout in the APROCO-COPILOTE cohort (ANRS CO-8). Qual Life Res. 2007;16(4):577–91.PubMedCrossRefGoogle Scholar
  113. 113.
    Brechtl JR, et al. The use of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection: impact on medical, palliative care, and quality of life outcomes. J Pain Symptom Manage. 2001;21(1):41–51.PubMedCrossRefGoogle Scholar
  114. 114.
    Wu AW, et al. Quality of life in a placebo-controlled trial of zidovudine in patients with AIDS and AIDS-related complex. J Acquir Immune Defic Syndr. 1990;3(7):683–90.PubMedGoogle Scholar
  115. 115.
    Fischl MA, et al. The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo-controlled trial. N Engl J Med. 1987;317(4):185–91.PubMedCrossRefGoogle Scholar
  116. 116.
    Gelber RD, et al. Quality-of-life evaluation in a clinical trial of zidovudine therapy in patients with mildly symptomatic HIV infection. The AIDS Clinical Trials Group. Ann Intern Med. 1992;116(12 Pt 1):961–6.PubMedCrossRefGoogle Scholar
  117. 117.
    Wu AW, Rubin HR, Mathews WG, Brysk LM et al. Functional Status and well-being in a placebo-controlled trial of zidovudine in early symptomatic HIV infection. J Acquir Immune Defic Syndr. 1993;6(5):452–8.Google Scholar
  118. 118.
    Lenderking WR, Gelber RD, Cotton DJ et al. Evaluation of the quality of life associated with zidovudine treatment in asymptomatic virus infection. The AIDS Clinical Trials Group. N Engl J Med. 1994;330(11):738–43.Google Scholar
  119. 119.
    Bozzette SA, Kanouse DE et al. The impact of zidovudine compared with didanosine on health status and functioning in persons with HIV infection and a varying duration of prior zidovudine therapy. AIDS Clinical Trials Group 116/117 Study Group. Antivir Ther. 1996; 1(1):21–32.Google Scholar
  120. 120.
    Shafer RW, et al. Comparison of four-drug regimens and pairs of sequential three-drug regimens as initial therapy for HIV-1 infection. N Engl J Med. 2003;349(24):2304–15.PubMedCrossRefGoogle Scholar
  121. 121.
    Yeni P, et al. Virological and immunological outcomes at 3 years after starting antiretroviral therapy with regimens containing non-nucleoside reverse transcriptase inhibitor, protease inhibitor, or both in INITIO: open-label randomised trial. Lancet. 2006;368(9532):287–98.PubMedCrossRefGoogle Scholar
  122. 122.
    Bucciardini R, et al. Health-related quality of life outcomes in HIV-infected patients starting different combination regimens in a randomized multinational trial: the INITIO-QoL substudy. AIDS Res Hum Retroviruses. 2007;23(10):1215–22.PubMedCrossRefGoogle Scholar
  123. 123.
    Hammer SM, et al. A controlled trial of two nucleoside analogues plus indinavir in persons with human immunodeficiency virus infection and CD4 cell counts of 200 per cubic millimeter or less. AIDS Clinical Trials Group 320 Study Team. N Engl J Med. 1997;337(11):725–33.PubMedCrossRefGoogle Scholar
  124. 124.
    Mukherjee J, Wu Y, Odeshoo L, Kelleher T, Uche Iloeje MAC, Giordano M. Atazanavir maintained patient utility and improved quality of life. Comparing favorably to LPV/RTV: 24-week data from BMS 043. 9th European AIDS conference, Warsaw; 2003.Google Scholar
  125. 125.
    Malan DR, et al. 96-week efficacy and safety of atazanavir, with and without ritonavir, in a HAART regimen in treatment-naive patients. J Int Assoc Physicians AIDS Care (Chic). 2010;9(1):34–42.CrossRefGoogle Scholar
  126. 126.
    Malan N, et al. Gastrointestinal tolerability and quality of life in antiretroviral-naive HIV-1-infected patients: data from the CASTLE study. AIDS Care. 2010;22(6):677–86.PubMedCrossRefGoogle Scholar
  127. 127.
    Huang IC, et al. Health-related quality of life and tolerability in treatment-experienced HIV-1-infected patients on tipranavir versus comparator regimens. Antivir Ther. 2008;13(1):15–25.PubMedGoogle Scholar
  128. 128.
    Dubois D, Smets E, Vangeneugden T, Van Baelen B, Viala M, Bhakar AL and Lefebvre E. Improved quality of life in treatment-experienced HIV patients treated with TMC114/r versus control protease inhibitors: results of POWER 1 and 2 functional assessment of HIV infection (FAHI). 16th International AIDS conference, Toronto; 2006.Google Scholar
  129. 129.
    Fumaz CR, et al. Quality of life, emotional status, and adherence of HIV-1-infected patients treated with efavirenz versus protease inhibitor-containing regimens. J Acquir Immune Defic Syndr. 2002;29(3):244–53.PubMedGoogle Scholar
  130. 130.
    Campo RE, et al. Switch from protease inhibitor- to efavirenz-based antiretroviral therapy improves quality of life, treatment satisfaction and adherence with low rates of virological failure in virologically suppressed patients. Int J STD AIDS. 2010;21(3):166–71.PubMedCrossRefGoogle Scholar
  131. 131.
    Potard V, et al. Better health-related quality of life after switching from a virologically effective regimen to a regimen containing efavirenz or nevirapine. AIDS Care. 2010;22(1):54–61.PubMedCrossRefGoogle Scholar
  132. 132.
    van Leth F, et al. Quality of life in patients treated with first-line antiretroviral therapy containing nevirapine and/or efavirenz. Antivir Ther. 2004;9(5):721–8.PubMedGoogle Scholar
  133. 133.
    Cooper V, et al. Beliefs about antiretroviral therapy, treatment adherence and quality of life in a 48-week randomised study of continuation of zidovudine/lamivudine or switch to tenofovir DF/emtricitabine, each with efavirenz. AIDS Care. 2011;23(6):705–13.PubMedCrossRefGoogle Scholar
  134. 134.
    Jayaweera D, et al. Virologic suppression, treatment adherence, and improved quality of life on a once-daily efavirenz-based regimen in treatment-Naive HIV-1-infected patients over 96 weeks. HIV Clin Trials. 2009;10(6):375–84.PubMedCrossRefGoogle Scholar
  135. 135.
    Hodder SL, et al. Patient-reported outcomes in virologically suppressed, HIV-1-Infected subjects after switching to a simplified, single-tablet regimen of efavirenz, emtricitabine, and tenofovir DF. AIDS Patient Care STDS. 2010;24(2):87–96.PubMedCrossRefGoogle Scholar
  136. 136.
    Airoldi M, et al. One-pill once-a-day HAART: a simplification strategy that improves adherence and quality of life of HIV-infected subjects. Patient Prefer Adherence. 2010;4:115–25.PubMedGoogle Scholar
  137. 137.
    Cella D, et al. Effects of etravirine versus placebo on health-related quality of life in treatment-experienced HIV patients as measured by the functional assessment of human immunodeficiency virus infection (FAHI) questionnaire in the DUET trials. HIV Clin Trials. 2010;11(1):18–27.PubMedCrossRefGoogle Scholar
  138. 138.
    Lalezari JP, et al. Enfuvirtide, an HIV-1 fusion inhibitor, for drug-resistant HIV infection in North and South America. N Engl J Med. 2003;348(22):2175–85.PubMedCrossRefGoogle Scholar
  139. 139.
    Lazzarin A, et al. Efficacy of enfuvirtide in patients infected with drug-resistant HIV-1 in Europe and Australia. N Engl J Med. 2003;348(22):2186–95.PubMedCrossRefGoogle Scholar
  140. 140.
    Cohen CJ, et al. Health-related quality of life with enfuvirtide (ENF; T-20) in combination with an optimized background regimen. J Acquir Immune Defic Syndr. 2004;37(1):1140–6.PubMedCrossRefGoogle Scholar
  141. 141.
    Bucciardini R, et al. T20QoL: an observational multicenter cohort study to evaluate the quality of life in HIV-patients treated with enfuvirtide (ENF, T-20) in combination with an optimized background therapy. Biologics. 2008;2(3):577–81.PubMedGoogle Scholar
  142. 142.
    Boulet T, et al. Impact on health-related quality of life of a switch from enfuvirtide to raltegravir among multidrug-resistant HIV-1-infected patients: a randomized open-label trial (EASIER-ANRS 138). HIV Clin Trials. 2010;11(5):283–93.PubMedCrossRefGoogle Scholar
  143. 143.
    Grant PM, et al. Switch from enfuvirtide to raltegravir in virologically suppressed HIV-1 infected patients: effects on level of residual viremia and quality of life. J Clin Virol. 2009;46(4):305–8.PubMedCrossRefGoogle Scholar
  144. 144.
    Sayana S, et al. Analysis of a switch from enfuvirtide to raltegravir in patients with undetectable viral load: efficacy and quality of life at 24 weeks. J Int Assoc Physicians AIDS Care (Chic). 2009;8(2):85–6.CrossRefGoogle Scholar
  145. 145.
    McDonald C, et al. Clinical significance of hyperbilirubinemia among HIV-1-infected patients treated with atazanavir/ritonavir through 96 weeks in the CASTLE study. AIDS Patient Care STDS. 2012;26(5):259–64.PubMedCrossRefGoogle Scholar
  146. 146.
    Corless IB, et al. Lipodystrophy-associated symptoms and medication adherence in HIV/AIDS. AIDS Patient Care STDS. 2005;19(9):577–86.PubMedCrossRefGoogle Scholar
  147. 147.
    Guaraldi G, et al. Severity of lipodystrophy is associated with decreased health-related quality of life. AIDS Patient Care STDS. 2008;22(7):577–85.PubMedCrossRefGoogle Scholar
  148. 148.
    Guaraldi G, et al. Lipodystrophy and quality of life of HIV-infected persons. AIDS Rev. 2008;10(3):152–61.PubMedGoogle Scholar
  149. 149.
    Guaraldi G, et al. Quality of life and body image in the assessment of psychological impact of lipodystrophy: validation of the Italian version of assessment of body change and distress questionnaire. Qual Life Res. 2006;15(1):173–8.PubMedCrossRefGoogle Scholar
  150. 150.
    Nicholas PK, et al. Lipodystrophy and quality of life in HIV: symptom management issues. Appl Nurs Res. 2005;18(1):55–8.PubMedCrossRefGoogle Scholar
  151. 151.
    Blanch J, et al. Impact of lipodystrophy on the quality of life of HIV-1 infected patients. J Acquir Immune Defic Syndr. 2002;31:404–7.PubMedCrossRefGoogle Scholar
  152. 152.
    Burgoyne R, et al. The relationship between lipodystrophy-associated body changes and measures of quality of life and mental health for HIV-positive adults. Qual Life Res. 2005;14(4):981–90.PubMedCrossRefGoogle Scholar
  153. 153.
    Rajagopalan R, Laitinen D, Dietz B. Impact of lipoatrophy on quality of life in HIV patients receiving anti-retroviral therapy. AIDS Care. 2008;20(10):1197–201.PubMedCrossRefGoogle Scholar
  154. 154.
    Steel JL, et al. Effects of lipodystrophy on quality of life and depression in HIV-infected men on HAART. AIDS Patient Care STDS. 2006;20(8):565–75.PubMedCrossRefGoogle Scholar
  155. 155.
    Antoniou T, et al. Long-term efficacy and safety of polyalkylimide gel for the treatment of HIV-associated lipoatrophy. AIDS Care. 2009;21(10):1247–52.PubMedCrossRefGoogle Scholar
  156. 156.
    Bechara FG, et al. Hyaluronic acid new formulation: experience in HIV-associated facial lipoatrophy. Dermatology. 2008;217(3):244–9.PubMedCrossRefGoogle Scholar
  157. 157.
    Carey D, et al. Poly-l-lactic acid for HIV-1 facial lipoatrophy: 48-week follow-up. HIV Med. 2009;10(3):163–72.PubMedCrossRefGoogle Scholar
  158. 158.
    Carey DL, et al. A randomized, multi-center, open-label study of poly-L-lactic acid for HIV-1 facial lipoatrophy. J Acquir Immune Defic Syndr. 2007;46(5):581–9.PubMedCrossRefGoogle Scholar
  159. 159.
    De Santis G, et al. Long-term efficacy and safety of polyacrylamide hydrogel injection in the treatment of human immunodeficiency virus-related facial lipoatrophy: a 5-year follow-up. Plast Reconstr Surg. 2012;129(1):101–9.PubMedCrossRefGoogle Scholar
  160. 160.
    Karim RB, et al. Long-term effect of polyalkylimide gel injections on severity of facial lipoatrophy and quality of life of HIV-positive patients. Aesthetic Plast Surg. 2008;32(6):873–8.PubMedCrossRefGoogle Scholar
  161. 161.
    Loutfy MR, et al. Four-year follow-up of polyalkylimide gel use for the treatment of HIV-associated lipoatrophy. HIV Clin Trials. 2011;12(6):323–32.PubMedCrossRefGoogle Scholar
  162. 162.
    Loutfy MR, et al. Immediate versus delayed polyalkylimide gel injections to correct facial lipoatrophy in HIV-positive patients. AIDS. 2007;21(9):1147–55.PubMedCrossRefGoogle Scholar
  163. 163.
    Mole B, et al. Polyacrylamide hydrogel injection in the management of human immunodeficiency virus-related facial lipoatrophy: results of the LIPOPHILL open-label study. AIDS Res Hum Retroviruses. 2012;28(3):251–8.PubMedCrossRefGoogle Scholar
  164. 164.
    Narciso P, et al. Immediate versus delayed surgical intervention for reconstructive therapy of HIV-associated facial lipoatrophy: a randomized open-label study. AIDS Res Hum Retroviruses. 2009;25(10):979–87.PubMedCrossRefGoogle Scholar
  165. 165.
    Negredo E, et al. Reconstructive treatment for antiretroviral-associated facial lipoatrophy: a prospective study comparing autologous fat and synthetic substances. AIDS Patient Care STDS. 2006;20(12):829–37.PubMedCrossRefGoogle Scholar
  166. 166.
    Rauso R, et al. Polyacrylamide gel injection for treatment of human immunodeficiency virus-associated facial lipoatrophy: 18 months follow-up. Dermatol Surg. 2011;37(11):1584–9.PubMedCrossRefGoogle Scholar
  167. 167.
    Warde M, et al. The impact of facial lipoatrophy treatment with polymethyl methacrylate in AIDS patients as measured by four quality-of-life questionnaires. Int J STD AIDS. 2011;22(10):596–9.PubMedCrossRefGoogle Scholar
  168. 168.
    Tramarin A, et al. Association between diarrhea and quality of life in HIV-infected patients receiving highly active antiretroviral therapy. Qual Life Res. 2004;13(1):243–50.PubMedCrossRefGoogle Scholar
  169. 169.
    Siddiqui U, et al. Prevalence and impact of diarrhea on health-related quality of life in HIV-infected patients in the era of highly active antiretroviral therapy. J Clin Gastroenterol. 2007;41(5):484–90.PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing Switzerland (outside the USA) 2013

Authors and Affiliations

  1. 1.Division of Infectious Diseases and Geographic MedicineStanford University School of MedicineStanfordUSA
  2. 2.VA Palo Alto Health Care SystemPalo AltoUSA

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