The two-year impact of first generation protease inhibitor based antiretroviral therapy (PI-ART) on health-related quali
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The two-year impact of first generation protease inhibitor based antiretroviral therapy (PI-ART) on health-related quality of life Lars E Eriksson*1,2,3, Göran A Bratt2, Eric Sandström2 and Gun Nordström1 Address: 1Department of Nursing, Karolinska Institutet, 23300, SE-141 83 Huddinge, Sweden, 2Department of Venhälsan, South Stockholm General Hospital, SE-118 83 Stockholm, Sweden and 3Department of Virology, Swedish Institute for Infectious Disease Control, SE-171 82 Solna, Sweden Email: Lars E Eriksson* - [email protected]; Göran A Bratt - [email protected]; Eric Sandström - [email protected]; Gun Nordström - [email protected] * Corresponding author
Published: 04 May 2005 Health and Quality of Life Outcomes 2005, 3:32 32
doi:10.1186/1477-7525-3-
Received: 16 December 2004 Accepted: 04 May 2005
This article is available from: http://www.hqlo.com/content/3/1/32 © 2005 Eriksson et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Protease inhibitor based antiretroviral therapy (PI-ART) was introduced in 1996 and has greatly reduced the incidence of HIV-related morbidity and mortality in the industrialised world. PI-ART would thus be expected to have a positive effect on health-related quality of life (HRQL). On the other hand, HRQL might be negatively affected by strict adherence requirements as well as by short and longterm adverse effects. The aim of this study was to assess the influence of two years of first generation PIART on HRQL in patients with a relatively advanced state of HIV-infection. Furthermore, we wanted to investigate the relation between developments in HRQL and viral response, self-reported adherence and subjective experience of adverse effects in patients with PI-ART. Methods: HRQL was measured by the Swedish Health-Related Quality of Life Questionnaire (SWEDQUAL). Sixty-three items from the SWED-QUAL forms two single-item and 11 multi-item dimension scales. For this study, two summary SWED-QUAL scores (physical HRQL composite score and emotional HRQL composite score) were created through a data reduction procedure. At the 2-year follow-up measurement (see below), items were added to measure adherence and subjective experience of adverse effects. Demographic and medical data were obtained from specific items in the questionnaires and from the medical files. Seventy-two patients who were among the first to receive PI-ART (indinavir or ritonavir based) responded to the questionnaire before the start of PI-ART. Of these, 54 responded to the same instrument after two years of treatment (13 had died, four had changed clinic and one did not receive the questionnaire). Results: The main findings were that the emotional HRQL deteriorated during two years of PI-ART, while the p
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