Esther A N Engelhard1,2, Colette Smit2, Peter R van Dijk3,4, T Martijn Kuijper5,6, Paulien R Wermeling7, Angelique E Weel5,6, Michiel R de Boer8, Kees Brinkman9, Suzanne E Geerlings1, Pythia T Nieuwkerk10. 1. Division of Infectious Diseases, Department of Internal Medicine, Academic Medical Center of the University of Amsterdam. 2. Stichting HIV Monitoring, Amsterdam. 3. Isala, Diabetes Centre, Zwolle. 4. Department of Internal Medicine, University of Groningen, University Medical Centre Groningen, Groningen. 5. Department of Rheumatology, Maasstad Hospital. 6. Department of Rheumatology, Erasmus MC University Medical Center, Rotterdam. 7. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht. 8. Section Methodology and Applied Biostatistics, Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam. 9. Department of Internal Medicine, Onze Lieve Vrouwe Gasthuis. 10. Department of Medical Psychology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: The health-related quality of life (HRQOL) of people with HIV is lower than in the general population, but it is unknown how it compares with that of persons with other chronic medical conditions. We compared HRQOL in HIV with HRQOL in diabetes mellitus type 1, diabetes mellitus type 2 and rheumatoid arthritis (RA). In addition, we investigated factors associated with HRQOL in HIV. DESIGN: Cross-sectional study. METHODS:HRQOL was measured with the Medical Outcomes Study Short Form 36-item Health Survey in a nationwide sample of people with HIV in care in the Netherlands and on combination antiretroviral therapy for at least 6 months. We added data from studies in diabetes mellitus types 1 and 2, and RA. Logistic regression analysis was used to examine: the association between disease group and a poor HRQOL, and patient factors associated with poor HRQOL in HIV. RESULTS: The odds of a poor physical HRQOL in the HIV group were comparable with the odds in diabetes mellitus types 1 and 2, but lower than in RA patients. The odds of a poor mental HRQOL in HIV were higher than in the other groups. In HIV, a history of AIDS, longer duration of combination antiretroviral therapy and severe comorbidity were associated with a poor physical HRQOL. Sub-Saharan African descent and CD4 cell count of less than 350 cells/μl were associated with poor mental HRQOL. CONCLUSION:People with HIV were more likely to have a poor mental HRQOL than patients with other chronic conditions. Addressing mental health should be an integral part of outpatient HIV care.
RCT Entities:
OBJECTIVES: The health-related quality of life (HRQOL) of people with HIV is lower than in the general population, but it is unknown how it compares with that of persons with other chronic medical conditions. We compared HRQOL in HIV with HRQOL in diabetes mellitus type 1, diabetes mellitus type 2 and rheumatoid arthritis (RA). In addition, we investigated factors associated with HRQOL in HIV. DESIGN: Cross-sectional study. METHODS: HRQOL was measured with the Medical Outcomes Study Short Form 36-item Health Survey in a nationwide sample of people with HIV in care in the Netherlands and on combination antiretroviral therapy for at least 6 months. We added data from studies in diabetes mellitus types 1 and 2, and RA. Logistic regression analysis was used to examine: the association between disease group and a poor HRQOL, and patient factors associated with poor HRQOL in HIV. RESULTS: The odds of a poor physical HRQOL in the HIV group were comparable with the odds in diabetes mellitus types 1 and 2, but lower than in RApatients. The odds of a poor mental HRQOL in HIV were higher than in the other groups. In HIV, a history of AIDS, longer duration of combination antiretroviral therapy and severe comorbidity were associated with a poor physical HRQOL. Sub-Saharan African descent and CD4 cell count of less than 350 cells/μl were associated with poor mental HRQOL. CONCLUSION:People with HIV were more likely to have a poor mental HRQOL than patients with other chronic conditions. Addressing mental health should be an integral part of outpatient HIV care.
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