Quality of life improvement in resource-limited settings after one year of second-line antiretroviral therapy use among adult men and women.

TitleQuality of life improvement in resource-limited settings after one year of second-line antiretroviral therapy use among adult men and women.
Publication TypeJournal Article
Year of Publication2018
AuthorsTorres TS, Harrison LJ, La Rosa AM, Cardoso SW, Zheng L, Ngongondo MN, Some F, Lalloo UG, Mwelase T, Collier AC, Hughes MD
Corporate AuthorsAIDS Clinical Trials Group(ACTG) A5273 Study Group
JournalAIDS
Volume32
Issue5
Pagination583-593
Date Published2018 Mar 13
ISSN1473-5571
Abstract

OBJECTIVE: We evaluated improvement of quality of life (QoL) after 1 year of second-line antiretroviral therapy (ART) use in resource-limited settings (RLS) among adult men and women, comparing two randomized treatment arms.

DESIGN: The AIDS Clinical Trial Group A5273 was a randomized clinical trial of second-line ART comparing lopinavir/ritonavir (LPV/r) + raltegravir with LPV/r + nucleos(t)ide reverse transcriptase inhibitors (NRTIs) in participants failing a non-NRTI-containing regimen at 15 sites in nine RLS. Participants completed the AIDS Clinical Trial Group short-form-21 which has eight QoL domains with a standard score ranging from 0 (worst) to 100 (best).

METHODS: Differences in QoL by randomized arm, as well as by demographic and clinical variables, were evaluated by regression models for baseline and week 48 QoL scores fitted using the generalized estimating equations method.

RESULTS: A total of 512 individuals (49% men, median age 39 years) were included. A total of 512 and 492 participants had QoL assessments at baseline and week 48, respectively. QoL improved significantly from baseline to week 48 (P < 0.001 for all domains). There was no significant difference between treatment arms for any domain. Individuals with higher viral load and lower CD4 cell count at baseline had lower mean QoL at baseline but larger improvements such that mean QoL was similar at week 48.

CONCLUSION: Improvements in QoL were similar after starting second-line ART of LPV/r combined with either raltegravir or NRTIs in RLS. QoL scores at baseline were lower among participants with worse disease status prior to starting second-line, but after 1 year similar QoL scores were achieved.

DOI10.1097/QAD.0000000000001738
Alternate JournalAIDS
PubMed ID29334547
PubMed Central IDPMC5832593
Grant ListUM1 AI069423 / AI / NIAID NIH HHS / United States
U01 AI069438 / AI / NIAID NIH HHS / United States
UM1 AI069476 / AI / NIAID NIH HHS / United States
UM1 AI069432 / AI / NIAID NIH HHS / United States
U01 AI069481 / AI / NIAID NIH HHS / United States
UM1 AI069438 / AI / NIAID NIH HHS / United States
UM1 AI069471 / AI / NIAID NIH HHS / United States
UM1 AI068634 / AI / NIAID NIH HHS / United States
UM1 AI069481 / AI / NIAID NIH HHS / United States
U01 AI069432 / AI / NIAID NIH HHS / United States
UM1 AI069399 / AI / NIAID NIH HHS / United States
U01 AI068636 / AI / NIAID NIH HHS / United States
UM1 AI069463 / AI / NIAID NIH HHS / United States
P30 AI027757 / AI / NIAID NIH HHS / United States
UM1 AI068636 / AI / NIAID NIH HHS / United States