Self-reported symptoms among HIV-lnfected patients on highly active antiretroviral therapy in the ATHENA cohort in The Netherlands.

BACKGROUND: HIV-infected patients on combination antiretroviral therapy (cART) may experience symptoms because of HIV disease or treatment. Symptoms might negatively affect quality of life, adherence, virological response, and survival. We investigated to what extent HIV-infected patients receiving cART experience symptoms with a median follow-up of 5.1 years. Additionally, we studied whether self-reported symptoms were related to concurrent quality of life and virological failure.
METHODS: Patients from the ATHENA cohort completed questionnaires on self-reported symptoms and quality of life every 6 months (January 1998 to June 2005). Quality of life was measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV), resulting in a physical health summary (PHS) score and a mental health summary (MHS) score. Growth curve models were conducted to investigate the course of symptoms. Random effect models were carried out to study the association with concurrent quality of life and virological response.
RESULTS: We included 391 patients, completing 2,851 questionnaires. Symptoms that increased significantly over time were numb feeling in fingers or toes (P < .01), pain in legs (P < .01), pain when urinating (P < .01), sore muscles (P = .02), tingling of hands or feet (P = .06), and difficulties with seeing (P < .01). All self-reported symptoms were related to lower levels of PHS and MHS (P < .01). Trouble with sleeping (odds ratio [OR] 1.5; 95% Cl, 1.04-2.2), constipation (OR 2.8; 95% Cl, 1.7-1.8), pain in legs (OR 1.8; 95% Cl, 1.2-2.6), and numb feeling in fingers or toes (OR 1.7; 95% Cl, 1.1-2.7) were related to concurrent virological response.
CONCLUSION: HIV-infected patients on cART report a large range of symptoms. Management of symptoms is relevant because a number of symptoms are related to poorer quality of life and virological failure.