Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme

dc.contributor.authorPitt, Jenniferen_ZA
dc.contributor.authorMyer, Landonen_ZA
dc.contributor.authorWood, Robinen_ZA
dc.date.accessioned2015-10-30T09:27:04Z
dc.date.available2015-10-30T09:27:04Z
dc.date.issued2009en_ZA
dc.description.abstractBACKGROUND:The impact of highly active antiretroviral therapy (HAART) on health-related quality of life has been widely researched in the developed world, but there are few data from sub-Saharan Africa, where the vast majority of HIV-infected individuals live. This study examined health-related quality of life among HIV-positive individuals initiating HAART in Cape Town, South Africa, and explored the impact of HAART-related drug toxicities on quality of life. METHODS: Health-related quality of life was assessed using a standardised questionnaire, the Medical Outcomes Survey Short Form 36. Physical health summary scores and mental health summary scores were compared pre-HAART and at regular intervals during the first 48 weeks of HAART. The relationships between socio-demographic, baseline and on-treatment variables and decline in health-related quality of life, as well as the impact of drug toxicities on quality of life, were assessed in unadjusted bivariate and adjusted multivariate analyses. RESULTS: Two hundred and ninety-five patients were enrolled into the study. There was a significant increase in health-related quality of life during the first 48 weeks on HAART. The median physical health summary score increased from 45 to 53 units (p < 0.001) and median mental health summary score increased from 45 to 50 units (p < 0.001).The bulk of this increase occurred during the first 16 weeks. Overall, 23% of participants experienced a decline in their physical health summary score, while 34% showed a decline in the mental health summary score. Average drops in median physical and mental health summary scores were 8.4 units (SD 9.31) and 9.9 (SD 11.4) units respectively. Participants with drug toxicity had lower physical health summary scores than participants without drug toxicity at all time points. However, only three participants with toxicity (27%) reported an actual decline in health-related quality of life by week 48. Drug toxicities had little impact on mental health summary scores. CONCLUSION: These results confirm the health-related quality of life benefits of HAART. While the majority of patients experienced a significant improvement in health-related quality of life on HAART, up to a third of patients reported declines in this quality of life. This was largely related to better baseline clinical state. HAART-related drug toxicities did not have a significant impact on health-related quality of life during the first year of HAART, which supports the ongoing use of the current national first-line regimen.en_ZA
dc.identifier.apacitationPitt, J., Myer, L., & Wood, R. (2009). Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme. <i>Journal of the International AIDS Society</i>, http://hdl.handle.net/11427/14497en_ZA
dc.identifier.chicagocitationPitt, Jennifer, Landon Myer, and Robin Wood "Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme." <i>Journal of the International AIDS Society</i> (2009) http://hdl.handle.net/11427/14497en_ZA
dc.identifier.citationPitt, J., Myer, L., & Wood, R. (2009). Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme. Journal of the International AIDS Society, 12(1), 5.en_ZA
dc.identifier.ris TY - Journal Article AU - Pitt, Jennifer AU - Myer, Landon AU - Wood, Robin AB - BACKGROUND:The impact of highly active antiretroviral therapy (HAART) on health-related quality of life has been widely researched in the developed world, but there are few data from sub-Saharan Africa, where the vast majority of HIV-infected individuals live. This study examined health-related quality of life among HIV-positive individuals initiating HAART in Cape Town, South Africa, and explored the impact of HAART-related drug toxicities on quality of life. METHODS: Health-related quality of life was assessed using a standardised questionnaire, the Medical Outcomes Survey Short Form 36. Physical health summary scores and mental health summary scores were compared pre-HAART and at regular intervals during the first 48 weeks of HAART. The relationships between socio-demographic, baseline and on-treatment variables and decline in health-related quality of life, as well as the impact of drug toxicities on quality of life, were assessed in unadjusted bivariate and adjusted multivariate analyses. RESULTS: Two hundred and ninety-five patients were enrolled into the study. There was a significant increase in health-related quality of life during the first 48 weeks on HAART. The median physical health summary score increased from 45 to 53 units (p < 0.001) and median mental health summary score increased from 45 to 50 units (p < 0.001).The bulk of this increase occurred during the first 16 weeks. Overall, 23% of participants experienced a decline in their physical health summary score, while 34% showed a decline in the mental health summary score. Average drops in median physical and mental health summary scores were 8.4 units (SD 9.31) and 9.9 (SD 11.4) units respectively. Participants with drug toxicity had lower physical health summary scores than participants without drug toxicity at all time points. However, only three participants with toxicity (27%) reported an actual decline in health-related quality of life by week 48. Drug toxicities had little impact on mental health summary scores. CONCLUSION: These results confirm the health-related quality of life benefits of HAART. While the majority of patients experienced a significant improvement in health-related quality of life on HAART, up to a third of patients reported declines in this quality of life. This was largely related to better baseline clinical state. HAART-related drug toxicities did not have a significant impact on health-related quality of life during the first year of HAART, which supports the ongoing use of the current national first-line regimen. DA - 2009 DB - OpenUCT DO - 10.1186/1758-2652-12-5 DP - University of Cape Town J1 - Journal of the International AIDS Society LK - https://open.uct.ac.za PB - University of Cape Town PY - 2009 T1 - Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme TI - Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme UR - http://hdl.handle.net/11427/14497 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14497
dc.identifier.urihttp://dx.doi.org/10.1186/1758-2652-12-5
dc.identifier.vancouvercitationPitt J, Myer L, Wood R. Quality of life and the impact of drug toxicities in a South African community-based antiretroviral programme. Journal of the International AIDS Society. 2009; http://hdl.handle.net/11427/14497.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDesmond Tutu HIV Centreen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2009 Pitt et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceJournal of the International AIDS Societyen_ZA
dc.source.urihttp://www.biomedcentral.com/1758-2652/en_ZA
dc.subject.otherAntiretroviral Therapyen_ZA
dc.titleQuality of life and the impact of drug toxicities in a South African community-based antiretroviral programmeen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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