Health-related quality of life in patients with human immunodeficiency virus infection in the United States: Results from the HIV cost and services utilization study
Rd. Hays et al., Health-related quality of life in patients with human immunodeficiency virus infection in the United States: Results from the HIV cost and services utilization study, AM J MED, 108(9), 2000, pp. 714-722
Citations number
40
Categorie Soggetti
General & Internal Medicine","Medical Research General Topics
PURPOSE: To measure health-related quality of life among adult patients wit
h human immunodeficiency virus (HIV) disease; to compare the health-related
quality of life of adults with HIV with that of the general population and
with patients with other chronic conditions; and to determine the associat
ions of demographic variables and disease severity with health-related qual
ity of life.
SUBJECTS AND METHODS: We studied 2,864 HIV-infected adults participating in
the HIV Cost and Services Utilization Study, a probability sample of adult
s with HIV receiving health care In the contiguous United States (excluding
military hospitals, prisons, or emergency rooms). A battery of 28 items co
vering eight domains of health (physical functioning, emotional well-being,
role functioning, pain, general health perceptions, social functioning, en
ergy, disability days) was administered. The eight domains were combined in
to physical and mental health summary scores. SF-36 physical functioning an
d emotional well-being scales were compared with the US general population
and patients with other chronic diseases on a 0 to 100 scale.
RESULTS: Physical functioning was about the same for adults with asymptomat
ic HIV disease as for the US population [mean (+/- SD) of 92 +/- 16 versus
90 +/- 17) but was much worse for those with symptomatic HIV disease (76 +/
- 28) or who met criteria for the acquired immunodeficiency syndrome (AIDS;
58 +/- 31). Patients with AIDS had worse physical functioning than those w
ith other chronic diseases (epilepsy, gastroesophageal reflux disease, clin
ically localized prostate cancer, clinical depression, diabetes) for which
comparable data were available. Emotional well-being was comparable among p
atients with various stages of HIV disease (asymptomatic, 62 +/- 9; symptom
atic, 59 +/- 11; AIDS, 59 +/- 11), but was significantly worse than the gen
eral population and patients with other chronic diseases except depression.
In multivariate analyses, HIV-related symptoms were strongly associated wi
th physical and mental health, whereas race, sex, health insurance status,
disease stage, and CD4 count were at most weakly associated with physical a
nd mental health.
CONCLUSIONS: There is substantial morbidity associated with HIV disease in
adults. The variability in health-related quality of life according to dise
ase progression is relevant for health policy and allocation of resources,
and merits the attention of clinicians who treat patients with HIV disease.
Am J Med. 2000;108:714-722. (C)2000 by Excerpta Medica, Inc.