ART Betters Quality of Life for People Living With HIV

Antiretroviral therapy (ART) has changed the disease course for patients living with HIV (PLWH), who now have a comparable life span to that of healthy individuals. In addition to positively impacting clinical outcomes, benefits from the treatment class can be seen in these patients’ quality of life (QOL), shows a new study in Revista de Saúde Pública.

The findings demonstrate that not only did overall QOL improve for these patients, but that there were also improvements in their physical, psychological, environmental, and spiritual well-being, as well as level of independence.

Improvements were seen across the 323 patients taking ART for at least 6 months, with patients’ physical QOL having the greatest mean (SD) improvements at 5.11 (3.75), followed by spiritual at 3.23 (6.20) and psychological at 1.32 (2.82).

“The greatest mean difference in QOL observed in the physical domain, in which aspects such as pain, discomfort, energy, sleep, and rest are evaluated, may be related to the use of ART,” note the researchers. “This causes changes in the course of infection, such as slowing the progression of immunodeficiency caused by the HIV virus and restoring the immune response of individuals—consequently, it can positively affect the individual’s life.”

Social relations was the only domain that did not see significant improvements in QOL, although living with other people was positively associated with QOL, highlighting the importance of family involvement for PLWH.

Improvements were measured by the World Health Organization quality of life HIV instrument brief.

“The social relationship is a complication for PLWH, since infection with the virus can be a stigmatizing health condition, which involves feelings of discrimination and, consequently, lack of social support and feelings of loneliness,” wrote the researchers. “Considering that these factors will hardly be influenced by the use of ART, it is important to emphasize the need to improve personal relationships and social support for these individuals.”

Having religious beliefs was also independently associated with an improved QOL while having signs or symptoms of anxiety or depression were negatively associated with QOL. Not surprisingly, adverse reactions to treatment negatively impacted QOL, with each additional reaction reported at baseline contributing to a reduction.

Based on these findings, the researchers highlighted the need to monitor and provide health care support, particularly for those with signs and symptoms or anxiety and depression and those who report adverse reactions at the beginning of treatment.

Reference

Pimental GS, Ceccato MdGB, Costa JdO, Mendes JC, Bonolo PdF, Silveira MR. Quality of life in individuals initiating antiretroviral therapy: a cohort study. Rev Saude Publica. Published online December 4, 2020. doi:10.11606/s1518-8787.2020054001920