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No break in QOL with treatment interruption A prolonged interruption in ART may result in symptom improvement among certain HIV-infected patients, with no adverse effect on QOL, according to a US-based study.1 In this study, 167 patients with HIV infections enrolled in the multicentre AIDS Clinical Trials Group (ACTG) 5170 underwent a voluntary interruption in their ART; patients had a CD4+ cell count of > 350 cells/mm3 at study entry, with a median time on ART of 4.5 years. Patients were followed up for 96 weeks, with QOL assessed at baseline, and at weeks 24, 48, 72 and 96 via patient self-report (0–100 scale), the patient-reported symptoms distress module, and the multidimensional health status tool (MHS). Following treatment interruption, the mean number of symptoms decreased from 8.2 at baseline to 7.0 at week 96 (p = 0.005). By weeks 24 and 48, the mean number of bothersome symptoms had also decreased from baseline, although this change was nonsignificant. In terms of QOL, there were no significant changes from baseline in the MHS mental or physical domain scores, with all scores remaining high over 96 weeks of follow-up; subjective QOL also remained high over the study period.

Medication type affects QOL QOL among HIV-positive patients is associated with the type of medication received, and not with sociodemographic variables, report researchers from Nigeria.2 They evaluated QOL in a random cross-section of 150 outpatients with HIV/AIDS; the Medical Outcomes Study (MOS)-HIV and Short-Form 36 (SF-36) health survey forms were used to evaluate QOL at baseline and 3 months’ follow-up. The overall mean QOL score at baseline was 78.2 using the MOS-HIV form (scale of 0–100); the baseline scores using the SF-36 were not significantly different to those obtained with the MOSHIV. Over 3 months of ART, patients receiving lamivudine/ stavudine/nevirapine and lamivudine/nevirapine/ emtricitabine + tenofovir disoproxil combinations generally had better QOL than those receiving other medications (p < 0.05). All patients reported receiving good family support. Patients stated financial problems (21.4%), emotional disturbances (28.6%) and discrimination (14.2%) as the most prevalent factors affecting their therapy. 1. Skiest D, et al. Patient reported symptoms improve following prolonged treatment interruption: ACTG 5170 quality of life results. 4th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention : 232 (plus poster) abstr. WEPEB076, 22 Jul 2007. 2. Osahon PT, et al. Quality of life of HIV positive patients being managed in HIV/AIDS treatment centre in Benin City, Nigeria. 4th International AIDS Society Conference on HIV Pathogenesis, Treatment and Prevention : 229, 22 Jul 2007. 801069711

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PharmacoEconomics & Outcomes News 11 Aug 2007 No. 534

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