People living with HIV
in the UK have poorer health-related quality of life (HRQoL) compared to
individuals in the general population, according to research presented at the recent Joint Conference of BHIVA (British HIV Association) with BASHH (British Association for Sexual Health and HIV).
The study compared
the results of two separate HRQoL surveys, one involving adults living with HIV,
the other adults in the general UK population. Both were conducted between 2010 and 2011.
The surveys measured five key aspects of health-related quality of life. People living with HIV were more
likely to report problems for each of these. HIV continued to be associated
with poorer health-related quality of life when the investigators controlled for confounding factors and
restricted their analysis to people living with HIV who were taking antiretroviral
therapy and had an undetectable viral load.
The investigators believe their
findings show the excess burden of ill health that continues to be associated
with HIV, even among people taking effective therapy.
There is a growing
body of research showing that people taking HIV therapy in richer countries
like the UK now have a normal life expectancy.
However, much less
is known about the health-related quality of life of people living with HIV in the modern treatment era.
A team of UK
investigators therefore designed a study comparing health-related quality of life between people living with HIV and HIV-negative individuals in the background UK population.
population comprised 3151 outpatients recruited to the ASTRA study. The
HSE study contributed 7424 individuals for the comparative HIV-negative group.
measured five aspects of health-related quality of life: mobility; self-care; ability to perform usual
activities such as work, study, housework, family or leisure activities;
pain/discomfort; and anxiety/depression. Answers were used to calculate a score
to indicate overall HRQoL.
The majority (95%)
of the participants who were living with HIV had a CD4 count above 200 cells/mm3 and
three-quarters were taking antiretroviral therapy with an undetectable viral
significant differences between the people living with HIV and the HIV-negative people in the study.
Individuals living with HIV were younger (median age 45 vs 49 years), more likely to
be male (81 vs 43%), more likely to be men who have sex with men (67 vs 1%) and more likely to be smokers (30 vs 26%).
However, people living with HIV were less likely to report heavy drinking (10 vs
20%), be in employment (58 vs 62%) or be of white race (81 vs 91%) (all
comparisons significant, p < 0.05).
proportion of people living with HIV than individuals in the general population
reported problems with each of the five measures of HRQoL.
- Mobility: 27 vs 20%
- Self-care: 13 vs 5%
- Usual activities: 34 vs 21%
- Pain: 42 vs 40%
- Anxiety/depression: 50 vs 27%
differences were significant (p < 0.05).
People living with HIV
also had a significantly lower overall HRQoL utility score (0.74 vs 0.82).
HIV was associated
with poorer health-related quality of life even after the investigators took into account factors such
as age, gender, ethnicity and smoking status (p < 0.001). The association
between HIV and poorer health-related quality of life also persisted when analysis was restricted to
people with a competent immune system and those with an undetectable viral
load taking antiretroviral therapy (p < 0.001).
associated with poorer health-related quality of life included older age, gender (female vs MSM),
smoking, lower levels of educational achievement (all p < 0.001) and
non-white ethnicity (p = 0.01).
therefore conclude that people living with HIV have poorer health-related quality of life than individuals in
the general population. They also believe their findings show HIV infection
continues to be associated with an excess burden of ill health in the era of effective