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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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Abstract

Purpose

We investigated HRQoL among HIV-positive outpatients from October, 2006-December, 2007, incorporating medical chart review, and a survey of coping styles.

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

AIDS:

Acquired immunodeficiency syndrome

ART:

Antiretroviral therapy

ARV:

Antiretroviral

HAART:

Highly active antiretroviral therapy

HIV:

Human immunodeficiency virus

HRQoL:

Health-related quality of life

IDGP:

Infectious disease group practice

IDU:

Intravenous drug user

IQR:

Inter-quartile range

MHS:

Mental health score

MOS:

Medical outcomes study

MSM:

Men who have sex with men

NRTI:

Nucleoside analog reverse transcriptase inhibitor

NNRTI:

Non-nucleoside analog reverse transcriptase inhibitor

PHS:

Physical health score

PI:

Protease inhibitor

SD:

Standard deviation

UCHSC:

University of Colorado Health Sciences Center

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Acknowledgments

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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Authors and Affiliations

  1. Children’s Hospital Colorado, Aurora, CO, USA

    Carl Armon

  2. National Jewish Health, Denver, CO, USA

    Kenneth Lichtenstein

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  1. Carl Armon
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  2. Kenneth Lichtenstein
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Correspondence to Carl Armon.

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Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the University of Colorado or its Adult General Clinical Research Center.

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Armon, C., Lichtenstein, K. 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. Qual Life Res 21, 993–1003 (2012). https://doi.org/10.1007/s11136-011-0017-2

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