Health-related quality of life of patients with HIV: impact of sociodemographic, clinical and psychosocial factors.

OBJECTIVES: This study aims to analyse how a wide group of clinical, social, demographic and psychological factors are related to both physical and mental quality of life in HIV + patients. DESIGN: A cross-sectional study was carried out of 320 HIV + patients in antiretroviral treatment who attended infectious diseases units in four hospitals in the region of Andalusia (Spain). METHODS: Health-Related Quality of Life was measured by the MOS-HIV. Included as independent variables were: sociodemographic variables, variables related to antiretroviral therapy, psychosocial variables like social support (Duke-UNC-11) and psychological morbidity (GHQ-28), variables related to main risk behaviours and clinical variables. RESULTS: In the multiple linear regression analysis, a better PHS quality of life was found to be associated with the absence of mental illness, social support, not being an intravenous drug user and using more than one type of non-injectable drug. A better quality of life, in mental terms, was found to be associated with fewer years as a non-intravenous drug user, having social support, absence of mental illness, not being an intravenous drug user taking only one additional pill, not having any difficulty in taking the medication, and being female. CONCLUSIONS: The study of other non-biological factors that may be related to quality of life has been limited practically to social support and the emotional state. This study highlights the importance of these factors independently from the clinical state, as well as the existence of other psychological and behavioural factors that are also related.

[The cost effectiveness of the study of the familial contacts of tuberculosis patients coinfected with the human immunodeficiency virus]. / Rentabilidad del estudio de los contactos familiares de enfermos con tuberculosis coinfectados por el virus de la inmunodeficiencia humana.

The investigation of contacts of patients with tuberculosis is a highly cost-effective measure to detect new cases of disease and infected individuals; nevertheless, its efficacy has not been contrasted with persons living with patients with tuberculosis (TB) coinfected with HIV. A total of 152 family contacts were studied corresponding to 84 HIV-positive tuberculosis patients. As a control group, 516 persons living with HIV-negative TB patients were included. Contacts were classified according to the bacteriologic status of the index case (IC): group I, contacts of patients with negative bacterioscopy and positive culture of respiratory specimens; group II, contacts of patients with negative bacterioscopy and positive culture of respiratory specimens, and group III, contacts of pulmonary and/or extrapulmonary TB patients with negative bacterioscopy and culture. Among IC coinfected with HIV there was a higher percentage of extrapulmonary clinical forms and therefore a lower proportion of bacillary forms, which accounted for a lower rate of infection among contacts of HIV-positive patients than among contacts of HIV-negative patients (20.4% vs 48.8%; OR: 3.7; 95% CI: 2.4-5.9). After controlling for bacteriologic status of the IC, differences remained when bacillary (group I) of HIV-coinfected patients were compared with those of patients not coinfected with HIV (35.9% vs 52.3%; OR: 2.1%; 95% CI: 1.2-5.9). Overall, 28 new TB cases were detected (4.2% of the total of studied persons living with TB patients) with no differences among contacts of both groups. The lower rate of infections among persons living with HIV-positive patients might be due not only to a lower number of pulmonary forms in HIV-coinfected IC and therefore less bacillary forms but also to a lower degree of crowding and a higher protection against exposure to their contacts.

[Percutaneous liver biopsy: comparative study on the efficacy of and tolerance to the automatic tru-cut technique]. / Biopsia hepática percutánea: estudio comparativo sobre la eficacia y tolerancia de la técnica de tru-cut automática.

Percutaneous liver biopsy (PLB) is an useful tool in accurately diagnosing difuse hepatopathy and systemic procedures like fever of unknown origin (FUO) and human immunodeficiency virus infection. Present job compares two different PLB procedures, automatic tru-cut needle versus Menghini needle. We have achieved 143 PLBs,74 of them through Menghini needle and 69 with automatic tru-cut technique. No differences were observed about diagnostic efficiency and secondary complications but we have noted a significant presence of pain reactions when Menghini needle is used. So we conclude that tru-cut technique is as safe as Menghini needle with the same diagnostic efficiency and better tolerance.