Correlation between Health-Related Quality of Life and Various Therapeutic Monitoring Parameters of Ivorian HIV-Infected Patients
Background: Health-related quality of life (HRQOL) is an important issue for HIV-infected patients on antiretroviral therapy (ART). The purpose of our study was to highlight particular items of HRQOL correlated to some monitoring parameters during ART in resource-limited settings (RLS): mean CD4 count, adherence, drug side effects (DSE), cotrimoxazole prophylaxis, self-medication and opportunistic infections.
Methods: HRQOL and self-medication were evaluated cross sectionally at eighteenth month of ART with 231 Ivorian HIV-infected patients. Our survey was performed using the MOS-HIV questionnaire for HRQOL. The mean
CD4 count during ART was determined with values measured at sixth month (M6), twelfth month (M12), eighteenth month (M18). Routine data from clinical visit at M6, M12, and M18 were used to assess longitudinally the quality of adherence, the occurrence of drug side effects and opportunistic infections during ART. These parameters were evaluated by each patient’s physician.
Results: Regardless of CD4 counts, scores of HRQOL items attached to them were homogeneous, (patients had an equivalent quality of life). Good adherence was significantly correlated with high general health perception scores, and overall quality of life component scores. Physical functioning and cognitive functioning were significantly influenced by the occurrence of DSE; scores of these items were higher without DSE. Considering the global HRQOL scores, the existence or not of cotrimoxazole prophylaxis did not influence differently the HRQOL scores. Patients who practiced self-medication had global HRQOL scores not significantly different from those who did not practice it. However, we found significant correlations between the practice of self-medication and mental health, energy/ fatigue and cognitive functioning. The scores of these items were greater in patients not practicing self-medication.
Conclusion: Information about therapeutic risks related to incomplete adherence, DSE and self-medication must be a crucial element integrated in counseling for HIV-infected patients to help optimize their HRQOL in RLS.