Quality of life in individuals initiating antiretroviral therapy: a cohort study

Authors

  • Gabriela Sales Pimentel Universidade Federal de Minas Gerais
  • Maria das Graças Braga Ceccato Universidade Federal de Minas Gerais
  • Juliana de Oliveira Costa University of New South Wales
  • Jullye Campos Mendes Universidade Federal de Minas Gerais
  • Palmira de Fátima Bonolo Universidade Federal de Minas Gerais
  • Micheline Rosa Silveira Universidade Federal de Minas Gerais

DOI:

https://doi.org/10.11606/s1518-8787.2020054001920

Keywords:

Anti-HIV Agents, Antiretroviral Therapy, Highly Active, Quality of Life, WHOQOLHIV-bref, Cohort Studies

Abstract

OBJECTIVE: To assess longitudinally the change in quality of life in people living with HIV initiating antiretroviral therapy in three public reference services specialized in HIV care in Belo Horizonte, Brazil. METHODS: Prospective cohort study among people living with HIV, aged 18 years or older, and initiating antiretroviral therapy. We obtained sociodemographic, behavioral, clinical data related to pharmacological treatment and to the service by face-to-face interviews, and supplemented these data with information from clinical records and Information Systems of the Brazilian HIV/AIDS Program. We measured the quality of life using the WHOQOL-HIV bref instrument, with a minimum interval of six months between the baseline and the follow-up interviews. We used paired t-test to assess the mean change in quality of life between the two interviewsand evaluated factors associated with this outcome using multiple linear regression. RESULTS: The overall quality of life, as well as the physical, psychological, level of independence, environment and spiritual quality of life domains were statistically higher in people living with HIV using antiretroviral therapy at the end of the follow-up. Factors independently associated with the increase in quality of life were having religious belief and living with other people. Having signs or symptoms of anxiety and depression and the number of adverse drug reactions reported were predictors associated with worsening quality of life. CONCLUSIONS: These results show an improvement in the quality of life over time in people living with HIV on antiretroviral therapy. They also highlight the need to monitor and provide health care support, especially for individuals with signs and symptoms of anxiety and depression and that report adverse reactions to medicines at the beginning of treatment.

Author Biographies

  • Gabriela Sales Pimentel, Universidade Federal de Minas Gerais

    Universidade Federal de Minas Gerais. Faculdade de Farmácia. Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica. Belo Horizonte, MG, Brasil

  • Maria das Graças Braga Ceccato, Universidade Federal de Minas Gerais

    Universidade Federal de Minas Gerais. Faculdade de Farmácia. Departamento de Farmácia Social. Belo Horizonte, MG, Brasil

  • Juliana de Oliveira Costa, University of New South Wales

    University of New South Wales. Centre for Big Data Research in Health. Faculty of Medicine. Sydney, Australia
    Universidade Federal de Minas Gerais. Faculdade de Medicina. Pós-Graduação em Saúde Pública. Belo
    Horizonte, MG, Brasil

  • Jullye Campos Mendes, Universidade Federal de Minas Gerais

    Universidade Federal de Minas Gerais. Faculdade de Farmácia. Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica. Belo Horizonte, MG, Brasil

  • Palmira de Fátima Bonolo, Universidade Federal de Minas Gerais

    Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brasil

  • Micheline Rosa Silveira, Universidade Federal de Minas Gerais

    Universidade Federal de Minas Gerais. Faculdade de Farmácia. Departamento de Farmácia Social. Belo Horizonte, MG, Brasil

References

World Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: recommendations for a public health approach. 2. ed. Genebra: WHO; 2016 [cited 2018 May 20]. Available from: http://www.who.int/hiv/pub/arv/arv-2016/en/.

Brasil. Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Vigilância, Prevenção e Controle das Infecções Sexualmente Transmissíveis, do HIV/aids e das Hepatites Virais. Protocolo clínico e diretrizes terapêuticas para manejo da infecção pelo HIV em adultos. Brasília; 2017.

Degroote S, Vogelaers D, Vandijck DM. What determines health-related quality of life among people living with HIV: an updated review of the literature. Arch Public Health. 2014;72(1). https://doi.org/10.1186/2049-3258-72-40.

Costa JO, Pearson SA, Acurcio FA, Bonolo PF, Silveira MR, Ceccato MGB. Health-related quality of life among HIV-infected patients initiating treatment in Brazil in the single-tablet regimen era. AIDS Care. 2019;31(5):572-81. https://doi.org/10.1080/09540121.2019.1576841.

Mendes JC et al. Adverse reactions associated with first-line regimens in patient initiating antiretroviral therapy. European Journal of Clinical Pharmacology. 2018;74(8):1077-88. https://doi.org/10.1007/s00228-018-2472.

Zimpel RR, Fleck MP. (2007). Quality of life in HIV-positive Brazilians: application and validation of the WHOQOL-HIV, Brazilian version. AIDS Care. 2007;19(7), 923-30. https://doi. org/10.1080/09540120701213765.

Botega NJ, Bio MR, Zomignani MA, Garcia Jr. C, Pereira WAB. Transtornos do humor em enfermaria de clínica médica e validação de escala de medida (HADS) de ansiedade e depressão. Rev. Saúde Pública. 1995:29(5):359-63.

Oliveira-Filho AD, Morisky DE, Neves SJ, Costa FA, Junior DPL. The 8-item Morisky Medication Adherence Scale: validation of a Brazilian-Portuguese version in hypertensive adults. Research in Social and Administrative Pharmacy. 2014;10(3):554-61. https://doi.org/10.1016/j. sapharm.2013.10.006.

Associação Brasileira de Empresas de Pesquisa. Critério de classificação econômica. Brasil: Abep; 2008. [cited 2019 Mar 5]. Available from: http://www.abep. org.

Field A. Descobrindo a estatística usando o SPSS-2. Porto Alegre: Bookman; 2009.

Grangeiro A, Escuder MM, Cassanote AJF, Souza RA, Kalichman AO, Veloso V et al. The HIV-Brazil cohort study: design, methods and participant characteristics. PLoS One. 2014;9(5):e95673. https://doi.org/10.1371/journal.pone.0095673.

Oliveira FBM, Moura MEB, Araújo TME, Andrade EMLR. Qualidade de vida e fatores associados em pessoas vivendo com HIV/aids. Acta paul. enferm. 2015;28(6):510-6. http://dx.doi. org/10.1590/1982-0194201500086.

Brasil. Ministério da Saúde, Secretaria de Vigilância em Saúde. Boletim epidemiológico de aids e DST. Brasília; 2018. [cited 2019 Feb 3]. Available from: http://www.aids.gov.br/pt-br/pub/2018/boletim-epidemiologico-hivaids-2018.

Minas Gerais. Secretaria Estadual de Saúde, Diretoria de Vigilância Epidemiológica, Coordenação de DST, Aids e Hepatites Virais. Boletim epidemiológico mineiro: análise epidemiológica de HIV/aids. Panorama do ano de 2017. Belo Horizonte; 2018. [cited 2019 Feb 5]. Available from: http://www.saude.mg.gov.br/images/noticias_e_eventos/000_2019/jane_fev_mar/BEM%20Mineiro%202018HIV.pdf.

Bakiono F, Guiguimdé PW, Sanou M, Ouédraogo L, Robert A. Quality of life in persons living with HIV in Burkina Faso: a follow-up over 12 months. BMC Public Health. 2015; 15(1119). http://dx.doi.org/10.1186/s12889-015-2444-4.

Liu C, Weber K, Robison E, Hu Z, Jacobson LP, Gange SJ. Assessing the effect of HAART on change in quality of life among HIV-infected women. AIDS Research and Therapy. 2006;3(6):1-11. http://dx.doi.org/10.1186/1742-6405-3-6.

Solomon S, Batavia A, Venkatesh KK, Brown L, Verma P, Cecelia AJ, Daly C, Mahendra VS, Kumarasamy N, Mayer KH. A longitudinal quality-of-life study of HIV-infected persons in South India: the case for comprehensive clinical care and support services. AIDS Education and Prevention. 2009;21(2):104-12. http://dx.doi.org/10.1521/aeap.2009.21.2.104.

Greco DB, Pedroso ERP, Westin MR. Síndrome da imunodeficiência adquirida. In: Pedroso ERP. Série medicina interna: doenças infecciosas. Rio de Janeiro: Rubio; 2015. p. 324-73.

Dutra BS, Lédo AP, Lins-Kusterer L, Luz E, Prieto IR, Brites C. Changes health-related quality of life in HIV-infected patients following initiation of antiretroviral therapy: a longitudinal study. Braz J Infect Dis. 2019;23(4):211-7. https://doi.org/10.1016/j.bjid.2019.06.005.

Gruszczyńska E, Rzeszutek M. Trajectories of health-related quality of life and perceived social support among people living with HIV undergoing antiretroviral treatment: does gender matter?. Front Psychol. 2019;23(10):1664. https://doi.org/10.3389/fpsyg.2019.01664.

Medeiros B, Saldanha AAW. Religiosidade e qualidade de vida em pessoas com HIV. Estud. psicol. 2012;29(1):53-61. https://dx.doi.org/10.1590/S0103-166X2012000100006.

Razera F, Ferreira J, Bonamigo RR. Factors associated with health-related quality-of-life in HIVinfected Brazilians. International Journal of STD & AIDS. 2008;19(8):519-23. https://dx.doi.org/10.1258/ijsa.2008.007289.

Baral R, Thapa U, Khatiwada D. Quality of life among people living with human immunodeficiency virus and acquired immune deficiency syndrome in an anti-retroviral therapy clinic. J Nepal Health Res Counc. 2019;16(41):405-9.

Tostes MA, Chalub M, Botega NJ. The quality of life of HIV-infected women is associated with psychiatric morbidity. AIDS Care. 2004;16(2):177-86. https://dx.doi.org/10.1080/09540120410001641020.

Souza Junior PRB, Szwarcwald CL, Castilho EA. Self-rated health by HIV-infected individuals undergoing antiretroviral therapy in Brazil. Cad. Saúde Pública. 2011;27(Suppl 1):s56-s66. http://dx.doi.org/10.1590/S0102-311X2011001300007.

Reis AC, Lencastre L, Guerra MP, Remor E. Relação entre sintomatologia psicopatológica, adesão ao tratamento e qualidade de vida na infecção HIV e AIDS. Psicol. Reflex. Crit. 2010;23(3):420-9. https://dx.doi.org/10.1590/S0102-79722010000300002.

Leserman J. Role of depression, stress, and trauma in HIV disease progression. Psychosom Med. 2008;70(5):539-45. https://dx.doi.org/10.1097/PSY.0b013e3181777a5f.

Yang Y, Thai S, Choi J. An evaluation of quality of life among Cambodian adults living with HIV/AIDS and using antiretroviral therapy: a short report. AIDS Care. 2016;28(12):1546-50. https://doi.org/10.1080/09540121.2016.1192100.

Campos LN, Cesar CC, Guimarães MD. Quality of life among HIV-infected patients in Brazil after initiation of treatment. Clinics. 2009;64(9):867-75. https://dx.doi.org/10.1590/S1807-59322009000900007.

Published

2020-12-12

Issue

Section

Original Articles

How to Cite

Pimentel, G. S., Ceccato, M. das G. B., Costa, J. de O., Mendes, J. C., Bonolo, P. de F., & Silveira, M. R. (2020). Quality of life in individuals initiating antiretroviral therapy: a cohort study. Revista De Saúde Pública, 54, 146. https://doi.org/10.11606/s1518-8787.2020054001920