Skip to main content

Quality of life in HIV subtype C infection among asymptomatic subjects and its association with CD4 counts and viral loads – a study from South India

Quality of Life Research volume 15, pages 1597–1605 (2006)Cite this article

Abstract

Objective

To study the association between quality of life (QOL) domains and biological markers of disease progression of HIV infection, i.e. viral load (VL) and CD4 counts among asymptomatic subjects with HIV subtype C infection in South India.

Design

Quality of life was measured using the locally validated version of the WHOQOL HIV-BREF. The subjects were neurologically asymptomatic, non psychiatrically ill HIV infected men and women participating in a cohort study.

Results

The results indicated mixed findings, with some QOL dimensions being associated with high VLs and low CD4 counts while several others did not show any associations. Significant associations were seen between low CD4 counts and the psychological and social relationships domain, with lower mean scores in these domains being reported by subjects having CD4 counts <200 /mm. However, there were no significant differences between the CD4 subgroups for the domains related to physical health, level of independence, environment, and spirituality domains. Significant lower mean QOL scores were found in the highest VL subgroup compared to other groups for the following WHOQOL HIV-BREF domains: physical, psychological, level of independence, and environmental.

Conclusions

In this sample of HAART naïve asymptomatic HIV infected subjects, some QOL dimensions were associated with the biological markers of disease progression i.e. VL and CD4 counts, while several were not. The associations were significant only in the high VL and low CD4 groups.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Wilson IB, Cleary PD (1995). Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA 23:59–65

    Article  Google Scholar 

  2. Wilson IB, Kaplan S (1995) Clinical practice and patients’ health status: How are the two related? Med Care 33:AS209–14

    PubMed  CAS  Google Scholar 

  3. O’Keefe EA, Wood R (1996). The impact of human immunodeficiency virus (HIV) infection on quality of life in a multi-cultural South African population. Qual Life Res 5:275–280

    Article  PubMed  CAS  Google Scholar 

  4. Tsevat J, Solzan JG, Kuntz KM et al. (1996). Health values of patients infected with HIV: Relationship to mental health and physical functioning. Med care 34:44–57

    Article  PubMed  CAS  Google Scholar 

  5. Wu AW, Hays RD, Kelly S, Malitz F, Bozzette SA (1997). Applications of the medical outcomes study health related quality of life measures in HIV/AIDS. Qual Life Res 6:531–534

    Article  PubMed  CAS  Google Scholar 

  6. Lubeck DP, Fries JF (1997). Assessment of quality of life in early stage HIV-infected persons: Data from AIDS Time-oriented Health Outcome Study (ATHOS). Qual Life Res 6:494–506

    Article  PubMed  CAS  Google Scholar 

  7. Siddappa NB, Dash PK, Mahadevan A, Jayasuryan N, Hu F, Dice B, Keefe R, Satish KS, Satish B, Sreekanthan K, Chatterjee R, Venu, K, Satishchandra P, Ravi V, Shankar SK, Shankarappa R, Ranga UJ (2004). Identification of subtype C human immunodeficiency virus type 1 by subtype-specific PCR and its use in the characterization of viruses circulating in the southern parts of India. Clin Microbiology 42:2742–2751

    Article  CAS  Google Scholar 

  8. Mellors JW, Rinaldo CR Jr, Gupta P et al. (1996). Prognosis in HIV-1 infection predicted by the qulity of virus in plasma. Science 7:1167–1170

    Article  Google Scholar 

  9. Mellors JW, Munoz A, Giorgi JV et al. (1997). Plasma viral load and CD4 lymphocytes as prognostic markers of HIV-1 infection. Ann Intern Med 126:946–954

    PubMed  CAS  Google Scholar 

  10. O’Brien WA, Hartigan PM, Daar ES, et al. (1997). Changes in plasma HIV RNA levels and CD4+ lymphocyte counts predict both response to antiretroviral therapy and therapeutic failure. Ann Intern Med 126: 939–45

    PubMed  CAS  Google Scholar 

  11. Lane HC, Laughon BE, Falloon J, et al. (1994) NIH Conference. Recent advances in the management of AIDS related opportunistic infections. Ann intern Med 120:944–945

    Google Scholar 

  12. Macarthur RD, Perez G, Walmsley S, Baxter JD, Mullin CM, Neaton JD. Terry Beirn community programs for clinical research on AIDS (CPCRA) 042/045; Canadian HIV trials network (CTN) 102 protocol teams. Comparison of prognostic importance of latest CD4+ cell count and HIV RNA levels in patients with advanced HIV infection on highly active antiretroviral therapy. HIV Clin Trials 2005; 6: 127–135.

    Google Scholar 

  13. Call SA, Kalpo JC, Stewert KE, et al. (2000). Health related quality of life and virologic outcomes in an HIV clinic. Qual Life Res 9:977–85

    Article  PubMed  CAS  Google Scholar 

  14. Lamping DL (1994). Methods for measuring outcomes to evaluate interventions to improve health related quality of life in HIV infection. Psychol Health 9:31–49

    Google Scholar 

  15. Gill CJ, Griffith JL, Jacobson D et al. (2002). Relationship of HIV Viral loads, CD4 counts and HAART use to Health-related Quality of Life. J AIDS 30:485–492

    Google Scholar 

  16. Bing EG, Hays RD, Jacobson LP et al. (2000). Health-related quality of life among people with HIV disease: Results from the Multicenter AIDS Cohort Study. Qual Life Res 9:55–63

    Article  PubMed  CAS  Google Scholar 

  17. Wig N, Lekshmi R, Pal H, Ahuja V, Mittal CM, Agarwal SK (2006). The impact of HIV/AIDS on the quality of life: A cross sectional study in north India. Indian J Med Sci 60:3–12

    Article  PubMed  Google Scholar 

  18. Kohli RM, Sane S, Kumar K, Paranjape RS and Mehendele SM (2005). Modification of medical outcome study (MOS) instrument for quality of life assessment & its validation in HIV infected individuals in India. Indian J Med Res 122:297–304

    PubMed  CAS  Google Scholar 

  19. Kohli RM, Sane S, Kumar K, Paranjape RS, Mehendele SM (2005). Assessment of quality of life among HIV-infected persons in Pune, India. Qual Life Res 14:1641–1647

    Article  PubMed  Google Scholar 

  20. Chandra PS, Deepthi V, Jairam KR, Thomas T (2003). Relationship of psychological morbidity and quality of life to illness-related disclosure among HIV-infected persons. J Psychosom Res 54(3):199–203

    Article  PubMed  Google Scholar 

  21. WHOQOL HIV Group (2003). Preliminary development of the World Health Organisation’s Quality of Life HIV instrument (WHOQOL-HIV: Analysis of pilot version. Soc Sci Med 57:1259–75

    Article  Google Scholar 

  22. WHOQOL HIV Group (2004). WHOQOL-HIV for quality of life assessment among people living with HIV and AIDS: Results from the field test. AIDS Care 16:882–9

    Article  Google Scholar 

  23. Wing JK, Babor T, Brugha T, et al. (1990). SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 47(6):589–93

    PubMed  CAS  Google Scholar 

  24. Beck AT and Steer RA (1993). Manual for the Beck Depression Inventory. San Antonio, Psychological Corporation

    Google Scholar 

  25. Chaturvedi SK, Chandra PS, Channabsavanna SM et al. (1994). Detection of Anxiety and Depression in Cancer Patients. NIMHANS J 12(2):141–144

    Google Scholar 

  26. Spielberger CD (1984) State-Trait Anxiety Inventory: A Comprehensive Bibliography. Consultant Psychologists Press, Palo Alto, CA

    Google Scholar 

  27. Saunders JB, Aasland OG, et al. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption-II.

  28. Nieuwkerk PT, Grsolf EH, Colebunders R, et al. (2004). Quality of life in asymptomatic- and symptomatic HIV infected patients in a trial of ritonavir/saquinavir therapy. The Prometheus study group. AIDS 14:181–187

    Article  Google Scholar 

  29. Revicki DA, Wu AW, Murray MI (1995). Change in clinical status, health status and health utility outcomes in HIV-infected patients. Med Care 33:AS173–AS182

    PubMed  CAS  Google Scholar 

  30. Anastos K, Barron Y, Cohen MH, Greenblatt RM, Minkoff H, Levine A, Younge M (2004). The prognostic importance of changes in CD4+ cell count and HIV-1 RNA level in women after initiating highly active antiretroviral therapy. Ann Intern Med 140:256–64

    PubMed  CAS  Google Scholar 

  31. Burgoyne RW, Roerke SB, Behrens DM, Salit IE (2004). Long-Term Quality of Life outcomes among adults living with HIV in the HAART Era: The interplay of changes in clinical factors and symptom profile. AIDS and Behavior 8(2):151–163

    Article  PubMed  Google Scholar 

  32. Weinfurt KP, Willke RJ, Glick HA et al. (2000). Relationship between CD4 count, viral burden and quality of life over time in HIV-1 infected patients. Med care 38:404–410

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This study is supported by an NIH R01 NS-41205 grant from NIH, USA. We acknowledge the support by all the Research Officers and Co-investigators from NIMHANS, Bangalore, India and University of Miami, USA

Author information

Authors and Affiliations

  1. Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, 560 029, India

    Prabha S. Chandra & Charu Gandhi

  2. Department of Neurology, National Institute of Mental Health and Neuro Sciences, Bangalore, India

    P. Satishchandra

  3. Department of Neurovirology, National Institute of Mental Health and Neuro Sciences, Bangalore, India

    Anupa Kamat, Anita Desai & V. Ravi

  4. Department of Bio-statistics, National Institute of Mental Health and Neuro Sciences, Bangalore, India

    D. K. Subbakrishna

  5. Department of Psychiatry and Behavioral Sciences, University of Miami School of Medicine, Miami, Florida, USA

    Raymond L. Ownby & Mahendra Kumar

Authors
  1. Prabha S. Chandra
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charu Gandhi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. P. Satishchandra
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anupa Kamat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anita Desai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. V. Ravi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Raymond L. Ownby
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. D. K. Subbakrishna
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mahendra Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Prabha S. Chandra.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Chandra, P.S., Gandhi, C., Satishchandra, P. et al. Quality of life in HIV subtype C infection among asymptomatic subjects and its association with CD4 counts and viral loads – a study from South India. Qual Life Res 15, 1597–1605 (2006). https://doi.org/10.1007/s11136-006-9001-7

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-006-9001-7

Keywords

  • CD 4 Counts
  • HIV
  • India
  • Quality of Life
  • Viral load