Abstract
BackgroundHealth-related quality of life (HRQoL) is considered to be the fourth 90 of UNAIDS 90-90-90 target to monitor the effects of combination antiretroviral therapy (ART). ART has significantly increased the life expectancy of people living with HIV/AIDS (PLWHA). However, the impact of chronic infection on HRQoL remains unclear, while factors influencing the HRQoL may vary from one country to another. The current study aimed to assess HRQoL and its associated factors among PLWHA receiving ART in Pakistan.MethodsA cross-sectional descriptive study was conducted among PLWHA attending an ART centre of a tertiary care hospital in Islamabad, Pakistan. HRQoL was assessed using a validated Urdu version of EuroQol 5 dimensions 3 level (EQ-5D-3L) and its Visual Analogue Scale (EQ-VAS).ResultsOf the 602 patients included in the analyses, 59.5% (n = 358) reported no impairment in self-care, while 63.1% (n = 380) were extremely anxious/depressed. The overall mean EQ-5D utility score and visual analogue scale (EQ-VAS) score were 0.388 (SD: 0.41) and 66.20 (SD: 17.22), respectively. Multivariate linear regression analysis revealed that the factors significantly associated with HRQoL were: female gender; age > 50 years; having primary and secondary education; > 1 year since HIV diagnosis; HIV serostatus AIDS-converted; higher CD 4 T lymphocytes count; detectable viral load; and increased time to ART.ConclusionsThe current findings have shown that PLWHA in Pakistan adherent to ART had a good overall HRQoL, though with significantly higher depression. Some of the factors identified are amenable to institution-based interventions while mitigating depression to enhance the HRQoL of PLWHA in Pakistan. The HRQoL determined in this study could be useful for future economic evaluation studies for ART and in designing future interventions.
Highlights
Health-related quality of life (HRQoL) is considered to be the fourth 90 of United Nations Programme on human immunodeficiency virus (HIV)/ AIDS (UNAIDS) 90-90-90 target to monitor the effects of combination antiretroviral therapy (ART)
Pakistan’s progress towards The Joint United Nations Programme on HIV/ AIDS (UNAIDS)’ 90-90-90 goal is lagging behind as only 14% of people living with human immunodeficiency virus and acquired immunodeficiency syndrome (HIV/AIDS) (PLWHA) are aware of their HIV status, only 10% are on treatment, while data on viral suppression are unavailable
Our findings suggested that several independent factors such as male gender, transgender, young age, being employed, having higher CD-4 lymphocytes count, undetectable viral load, higher education level, and being asymptomatic were significantly associated with higher HRQoL
Summary
Health-related quality of life (HRQoL) is considered to be the fourth 90 of UNAIDS 90-90-90 target to monitor the effects of combination antiretroviral therapy (ART). ART has significantly increased the life expectancy of people living with HIV/AIDS (PLWHA). The current study aimed to assess HRQoL and its associated factors among PLWHA receiving ART in Pakistan. Conclusions The current findings have shown that PLWHA in Pakistan adherent to ART had a good overall HRQoL, though with significantly higher depression. The use of Highly Active Antiretroviral Therapy (HAART) in PLWHA results in viral load (VL) suppression [6], boosts the immune system [7], and contributes to improving their health-related quality of life (HRQoL) [8].
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