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Psychometric assessment of health-related quality of life and symptom experience in HIV patients treated with antiretroviral therapy

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Abstract

Purpose

Symptoms which are found to cluster consistently can have synergistic effects on patient outcomes and therefore may serve to predict morbidity or disentangle disease progression from comorbid conditions. Self-report HIV-specific symptom and HRQL measures were jointly analyzed in HIV-positive patients under different antiretroviral treatment regimens.

Methods

The responses of \(N=365\) patients from four countries to the 9-item Physical Health and Symptom dimension of the PROOQL-HIV questionnaire and an HIV Symptom checklist were analyzed. Item response modeling and multidimensional scaling were used to derive HRQL scores free of any differential item functioning related to gender and target language and to summarize symptom co-expression in patients under protease inhibitor treatment (PI, \(N=164\), 45 %) versus other medication (Non-PI).

Results

Women reported poorer HRQL (\(p=0.037\)), and HRQL did not differ between the target languages of French, English, and Thai. Fatigue, muscular pain, or difficulties falling asleep was the most frequently reported symptoms >35 %). PI versus Non-PI patients exhibited different pattern of symptoms with lipodystrophy-related and gastrointestinal symptoms forming well-separated clusters in the PI group. A higher number of symptoms were associated with lower HRQL (\(p < 0.001\)), and patients taking PIs reported lower HRQL (\(p=0.003\)). Patients in both groups who reported fatigue, sexual dysfunction, or several lipodystrophy-related symptoms had poorer quality of life.

Conclusion

The co-expression of symptoms and their relation to HRQL are important aspects for the monitoring of HIV treatments.

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Acknowledgments

The authors would like to thank the following persons for data collection and monitoring during the validation of the PROQOL-HIV questionnaire: Simon Mallal, Noel Hyland, Institute for Immunology and Infectious Diseases, Murdoch University and Royal Perth Hospital, Australia; Agnès Levy, Anne Persoz, Alioune Blondin-Diop, Patricia Assal, Olivier Seégeral, Sylvie Cheneau, Sophie Ismael, Juliette Baillon, Valérie Morin, Martine Mole, Marie-Thérèse Rannou, Marie-Stéphanie Nguessan, Sandrine Pottez, Cécile Goujard, Jean-François Delfraissy, Bicêtre hospital, Paris, France; Pascale Leclerc, CHU Grenoble, France; Social Science Working Group, ANRS, Paris, France; Veronica Noseda, Vincent Douris, Marc Dixneuf, Paola de Carli, Sidaction, Paris, France; Virat Klinbuayaem, Suwalai Chalermpantmetagul, Surush Sununta, Institut de Recherche pour le Deéveloppement, Research Unit 174 (IRD/Faculty of Associated Medical Sciences, Chiang Mai University/Harvard, School of Public Health), Chiang Mai, Thailand; Institut dEtudes Dém ographiques, Paris, France. Robert Murphy, Kimberly Sauls-Berry, Center for Global Health, Division of Infectious Diseases, Northwestern University, Chicago, IL; Baiba Berzins, Center for Global Health, Division of Infectious Diseases, Northwestern University, Chicago, IL.

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Authors and Affiliations

  1. Patient-Centered Outcomes Research, Paris Sorbonne Cité, EA, 7334 (REMES), University Paris Diderot, Paris, France

    Christophe Lalanne, Olivier Chassany & Martin Duracinsky

  2. Department of Clinical Research, AP-HP, Saint-Louis Hospital, Paris, France

    Christophe Lalanne & Olivier Chassany

  3. Australian Institute of Family Studies, Melbourne, VIC, 3000, Australia

    Andrew R. Armstrong

  4. Murdoch University, Murdoch, Perth, Australia

    Susan Herrmann

  5. Institut National d’Etudes Démographiques, Paris, France

    Sophie Le Coeur

  6. UMI 174, Institut de Recherche pour le Développement, Program for HIV Prevention and Treatment, Chiang Mai, Thailand

    Sophie Le Coeur

  7. INSERM, U912 (SESSTIM), Marseille, France

    Patrizia Carrieri

  8. UMR-S912, IRD, University Aix Marseille, Marseille, France

    Patrizia Carrieri

  9. AP-HP, Bicêtre Hospital, Internal Medicine and Clinical Immunology, Le Kremlin-Bicêtre, France

    Martin Duracinsky

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  1. Christophe Lalanne
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Correspondence to Christophe Lalanne.

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Lalanne, C., Armstrong, A.R., Herrmann, S. et al. Psychometric assessment of health-related quality of life and symptom experience in HIV patients treated with antiretroviral therapy. Qual Life Res 24, 1407–1418 (2015). https://doi.org/10.1007/s11136-014-0880-8

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