QUALITY-OF-LIFE AND HEALTH-SERVICE USE AMONG HIV-INFECTED PATIENTS WITH CHRONIC DIARRHEA

Health-related quality of life and the utilization of health resources are important components of the evaluation of patient outcome in HIV infection because medical problems are often progressive and debilitat ing, and treatment is palliative. We evaluated quality-of-life measure s and resource utilization of patients with AIDS and/or CD4 lymphocyte s < 200 who had symptoms of chronic diarrhea and compared them with si milar patients with AIDS and/or CD4 lymphocytes < 200 without diarrhea l symptoms. Annual charges were 50% higher for patients with chronic d iarrhea ($24,567 versus $14,471 for the comparison group, p < 0.01). H igher charges for the patients with diarrhea were a result of more phy sician visits and diagnostic testing. Quality-of-life scores were poor for all patients, but deterioration over the year in role functioning (social activity, daily living, energy, cognition) and general health was clearly evident (p < 0.01) for the patients with chronic diarrhea . These patients also suffered significant work loss and reported grea ter need for assistance in the home. These data suggest that HIV-infec ted patients with diarrhea experience marked decreases in quality of l ife and that care for patients with chronic diarrhea is costly. Relati vely little attention has been paid to this debilitating syndrome, and current treatment options rarely provide permanent relief. Research a nd innovation in this area are needed; an estimated 25-50% of HIV-posi tive individuals suffer from this symptom complex.