DIARRHEA AND QUALITY-OF-LIFE IN AMBULATORY HIV-INFECTED PATIENTS

Our objectives were to determine HIV-infected patients' awareness and recognition of diarrheal symptoms; and to assess the impact of diarrhe a on quality of life. The design was a cross-sectional study utilizing a structured telephone interwiew. The setting was the HIV/AIDS outpat ient clinic of a tertiary referral hospital. HIV-infected patients who attended the clinic in 1994 were interviewed, The main outcome measur e was the quality-of-life score (QLS), Fifty percent of patients ackno wledged having diarrhea in the previous month. All four categories of diarrhea (self-reported or elicited, within the preceding week or mont h) were significantly associated with decreased QLS. Patients with dia rrhea who did not recognize their symptoms as diarrhea also had signif icantly lower QLS than patients without diarrhea. Diarrhea in all cate gories was independently predictive of decreased QLS by multivariable analysis. Chronic diarrhea (symptoms for more than one month) was sign ificantly associated with decreased QLS ill patients with high as well as lover CD4 cell counts. Lack of recognition of diarrhea may result in significant underreporting of diarrhea by patients to physicians, D iarrhea is highly prevalent in the HIV-infected population and is stro ngly associated with diminished quality of life.