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1.
J Antimicrob Chemother ; 61(3): 469-73, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18174196

RESUMEN

Advances in highly active antiretroviral therapy (HAART) options for people living with HIV/AIDS have resulted in decreased morbidity and mortality. To some extent, the role of disease progression in eroding quality of life (QOL) erosion in the pre-HAART age is now supplanted by drug toxicities, one of the Achilles' heels of HAART. This article reviews research findings on treatment and QOL outcomes a decade into the HAART era.


Asunto(s)
Terapia Antirretroviral Altamente Activa/métodos , Infecciones por VIH/tratamiento farmacológico , Cuidados para Prolongación de la Vida/métodos , Calidad de Vida , Adulto , Terapia Antirretroviral Altamente Activa/efectos adversos , Enfermedades Gastrointestinales/inducido químicamente , Enfermedades Gastrointestinales/fisiopatología , Infecciones por VIH/fisiopatología , Humanos , Cuidados para Prolongación de la Vida/tendencias
2.
AIDS Behav ; 10(3): 273-7, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16421650

RESUMEN

Lipodystrophy severity among 77 people living with HIV/AIDS (PHA) with body fat redistribution was not related to antiretroviral adherence including doses missed during the previous month, categorical rating of maximal adherence, and the PMAQ7 adherence behavior scale. Two thirds of the sample reported submaximal adherence, 19% missing more than two doses, but adherence behavior ratings reflected good overall adherence. Overall symptom burden, convenience of regimen schedule and remembering to organize and take antiretroviral doses, but not regimen adaptation or treatment support, were associated with adherence. Remembering was most strongly related to adherence indicators, retaining statistical significance in adjusted multivariate regression analyses.


Asunto(s)
Terapia Antirretroviral Altamente Activa/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Síndrome de Lipodistrofia Asociada a VIH , Negativa del Paciente al Tratamiento/estadística & datos numéricos , Anciano , Femenino , Síndrome de Lipodistrofia Asociada a VIH/diagnóstico , Síndrome de Lipodistrofia Asociada a VIH/epidemiología , Síndrome de Lipodistrofia Asociada a VIH/etiología , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Apoyo Social
3.
AIDS Behav ; 8(2): 151-63, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15187477

RESUMEN

Changes in quality-of-life perceptions and their relations to clinical status for 41 adult outpatients living with HIV/AIDS were assessed over a 4-year period. Clinical variables and quality-of-life (Medical Outcomes Study Short-Form-36) ratings were measured in three waves (T1, 1997; T2, 1999; T3, 2001). Mean T1-T3 CD4 increase was 196 cells/microL (p < .0001), corresponding to a mean viral load reduction of 1.4 log10 copies/mL (p < .0001) and an increase in proportions with "undetectable" viral load status from 32% to 61% (p < .01). The T1-T2 increase in overall mean number of symptoms (including both disease-related symptom complex and treatment side effects) was mitigated by T2-T3 symptom reduction. Quality-of-life dimensions were generally stable or slightly improved over time for the overall sample, a finding that contrasts with pre-highly active antiretroviral therapy longitudinal research. Mental aspects of quality of life remained consistently lower than reference norms. Results of multiple regression suggested that quality of life was less sensitive to immunologic/virologic changes compared to responsiveness to symptom changes, consistent with cross-sectional inverse relations between symptom burden and quality of life. CD4 repletion offset negative effects of symptoms for some aspects of quality of life. The long-term course of quality of life was somewhat predicted by viral load suppression due to the conjoint influence of symptoms and CD4 count.


Asunto(s)
Terapia Antirretroviral Altamente Activa , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Calidad de Vida , Adulto , Anciano , Recuento de Linfocito CD4 , Femenino , Estado de Salud , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Percepción , Análisis de Regresión , Carga Viral
4.
Int J STD AIDS ; 13(10): 683-90, 2002 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-12396538

RESUMEN

Quality of life (QoL) changes among 56 adult patients living with HIV/AID (PHA) were assessed following two years of care in which most had received highly active antiretroviral therapy (HAART). The sample was stratified by initial disease stage; subjects were classified 'asymptomatic' if they had no HIV-related constitutional symptoms, 'symptomatic' if they had at least one symptom, and 'AIDS' if symptomatic with a history of opportunistic infections and/or CD4 count less than 200 cells/ micro L. For the overall group, changes in mean QoL (Medical Outcomes Study Short-Form-36 [SF-36]) ratings were non-significant, irrespective of initial disease stage or prior HAART exposure. Although overall there were health status improvements over the two-year period, clinical changes were generally unrelated to changes in QoL ratings. Patients with better immunologic/virologic outcomes showed slight improvements in mean QoL ratings, while those with poorer clinical outcomes showed slight deterioration. These within-group changes over time were statistically non-significant. The corresponding between-group differences in changes in SF-36 social and psychological dimensions were significant. Statistically significant differences among the three disease stage groups on a number of subscales at baseline (Physical Function, Body Pain, Vitality, Role Limitations due to Physical Problems) became non-significant (i.e. nullified) at follow-up. Significant increases in mean number of symptoms for the asymptomatic and symptomatic groups were not associated with two-year changes in QoL ratings. Overall, wellbeing was moderately stable over the two-year follow-up period, although somewhat affected by symptom changes and immunologic/virologic outcome. The study results contrast with pre-HAART longitudinal research, in which deterioration in all areas of QoL occurred.


Asunto(s)
Terapia Antirretroviral Altamente Activa/psicología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/psicología , Indicadores de Salud , Calidad de Vida/psicología , Adulto , Recuento de Linfocito CD4 , Distribución de Chi-Cuadrado , Femenino , Estudios de Seguimiento , Infecciones por VIH/inmunología , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Pacientes Ambulatorios/psicología , Encuestas y Cuestionarios , Carga Viral
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