Impact of Advanced HIV Disease on Quality of Life and Mortality in the Era of Combined Antiretroviral Treatment
Por:
Portilla-Tamarit, J, Reus, S, Portilla, I, Ruiz-de-Apodaca, M and Portilla, J
Publicada:
1 feb 2021
Ahead of Print:
11 feb 2021
Resumen:
Currently, AIDS or severe immunodeficiency remains as a challenge for people with HIV (PWHIV) and healthcare providers. Our purpose was to analyze the impact of advanced HIV disease (AHD) on mortality, life expectancy and health-related quality of life (HRQoL). We reviewed cohort studies and meta-analyses conducted in middle- and high-income countries. To analyze HRQoL, we selected studies that reported overall health and/or physical/mental health scores on a validated HRQoL instrument. AIDS diagnosis supposes a higher risk of mortality during the first six months, remaining higher for 48 months. It has been reported that cancer and cardiovascular disease persist as frequent causes of mortality in PWHIV, especially those with previous or current AHD. PWHIV who initiate combination antiretroviral therapy (cART) with CD4 < 200 cells/mu L have significantly lower estimated life expectancy than those with higher counts. AHD is associated with lower HRQoL, and a worse physical health or mental health status. AIDS and non-AIDS defining events are significant predictors of a lower HRQoL, especially physical health status. AHD survivors are in risk of mortality and serious comorbidities, needing special clinical attention and preventive programs for associated comorbidities. Their specific needs should be reflected in HIV guidelines.
Filiaciones:
:
Alicante Univ Gen Hosp, Internal Med Dept, Infect Dis Unit, Alicante 03010, Spain
Alicante Inst Hlth & Biomed Res ISABIAL, Alicante 03010, Spain
:
Alicante Univ Gen Hosp, Internal Med Dept, Infect Dis Unit, Alicante 03010, Spain
Alicante Inst Hlth & Biomed Res ISABIAL, Alicante 03010, Spain
Miguel Hernandez Univ, Dept Clin Med, Alicante 03207, Spain
:
Alicante Inst Hlth & Biomed Res ISABIAL, Alicante 03010, Spain
Univ Alicante, Dept Hlth Psychol, Alicante 03690, Spain
Ruiz-de-Apodaca, M:
Natl Distance Learning Univ UNED, Fac Psicol, Psicol Social & Org, Madrid 28015, Spain
Spanish Interdisciplinary AIDS Soc SEISIDA, Madrid 28036, Spain
:
Alicante Univ Gen Hosp, Internal Med Dept, Infect Dis Unit, Alicante 03010, Spain
Alicante Inst Hlth & Biomed Res ISABIAL, Alicante 03010, Spain
Miguel Hernandez Univ, Dept Clin Med, Alicante 03207, Spain
Carlos III Hlth Inst, Spanish AIDS Res Network, Madrid 28029, Spain
Gold, Green Published
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