Abstract:
Background: Several studies have been conducted on the clinical outcomes of patients on different of antiretroviral regimens, but not on their health-related quality of life (HRQoL) outcomes. These clinical outcomes are not always the reflection of good wellbeing of the patients.
Objectives: To evaluate the health-related quality of life of patients on different WHO-recommended antiretroviral regimens and the effects of their sociodemographic and clinical characteristics on their HRQoL.
Methods: A cross-sectional descriptive design was used to evaluate HRQoL of patients receiving antiretroviral treatment at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokotoin North-Western Nigeria. Consenting 872 adult outpatients that were on their current antiretroviral regimen for at least six months were studied from the periods of May to November, 2015. Sociodemographic, clinical and medication data were collected. Data on the patients’ HRQoL were collected using the validatedHIV/AIDS-Targeted Quality of Life (HAT-QoL) instrument. Patients’ responses were converted to 0 to 100 linear scale. Data wereanalysed using the SPSS version 16. Descriptive statistics, Chi square, Students’ T-test, One-way ANOVA, bivariate correlation and linear regression were carried out appropriately. Level of significance was set at P<0.05.
Results: The overall HRQoL score of the patients was 59.40(±18.66). Lowscores were seen in the domains of Health Worries (30.36±21.03), Disclosure Worries (34.75±28.73) and Financial Worries (38.67±22.14). Among the firs-line regimens, patients on TDF+FTC+EFZ (60.52±19.17), and those on TDF+3TC+EFZ (64.41±18.04)reported the best HRQoL scores. The difference between the scores of patients on the two most utilised regimens; AZT+3TC+NVP (58.14±18.53) and TDF+3TC+EFZ (64.41±18.04) was significant. Among patients on second-line regimens, those on TDF+FTC+LPVr (67.58±14.80) reported the highest HRQoL score. Patients with co-morbidity reported lower HRQoL scores. Patients who are female, singleand those with lower body weight and lower level of education also reported lower HRQoL scores. Clinical stage and CD4 count were significantly negatively and positively correlated with HRQoL, respectively.
Conclusion: Patients in the facility had a moderate HRQoL. TDF+3TC+EFZ, TDF+FTC+EFZ and TDF+FTC+LPVr were the regimens with the best HRQoL outcomes. Co-morbid state, female gender, single marital status, lower body weight, lower level of education, higher clinical stage, and lower CD4 count were all associated with low HRQoL outcomes. The prediction of HRQoL by CD4 count and clinicalstage is weak. Hence, the need for routine HRQoL evaluation of patients for better outcome evaluation.
