PIN159 Factors Associated with Health-Related Quality of Life and Medical Costs of People Living with HIV in Italy

Abstract

The aim of the study was to assess factors that may be associated with Health-Related Quality of Life (HRQoL) and medical costs of people living with HIV (PLHIV) in Italy. A cross-sectional analysis of a cohort of 651 Italian PLHIV on antiretroviral therapy (ART) for ≥6 months was conducted. Good adherence was defined as no self-reported missing pills or medications via questionnaire. HIV symptoms and HRQoL were measured by ISS-QoL scale and EQ-5D questionnaire, respectively. PLHIV were categorized as high or low risk group according to transmission routes. The medical costs were calculated based on patients’ health records, with ART and HCV drug costs included. Hierarchical regression model was used to explore the factors of HRQoL and costs at a significance level of 0.05. The mean age was 48.3 years and 79.0% were male. Most PLHIV had good adherence (90.9%), were virologically suppressed (94.6% with a viral load ≤ 37 copies/mL) and had high CD4 cell counts (77.1% with CD4 > 500 cells/mm3). The mean (SD) of HRQoL was 0.87 (0.18). The HRQoL analysis indicated that Caucasian race (β=0.090, p=0.009), longer HIV duration (β=0.098, p=0.010), use of a single-tablet regimen (β=0.133, p<0.001), absence of any comorbidities (p<0.001), being adherent (β=0.087, p=0.026), and mild and moderate HIV symptoms (β=0.374, p<0.001) were independent predictors of better HRQoL. The costs model showed that older age (β=0.067, p=0.023), high risk group (β=0.054, p=0.035), use of a multi-tablet regimen (β=0.074, p=0.011), and presence of more comorbidities (β=0.059, p=0.019), especially HCV co-infection (β=0.746, p<0.001) and neurocognitive impairment (β=0.065, p=0.031), were predictors of an increased annual medical costs of PLHIV. In the real-world setting, single-tablet or multi-tablet regimen, adherence, and comorbidities are associated with HRQoL and medical costs of PLHIV, higlighting the needs for additional interventions to promote well-being in PLHIV.