Impact of antiretroviral therapy on quality of life in HIV-infected Southeast Asian children in the PREDICT study
Bunupuradah, T.; Kosalaraksa, P.; Vibol, U.; Hansudewechakul, R.; Sophonphan, J.; Kanjanavanit, S.; Ngampiyaskul, C.; Wongsawat, J.; Luesomboon, W.; Vonthanak, S.; Ananworanich, J.; Ruxrungtham, K.; Puthanakit, T.; Phanuphak, P.; Cooper, D.A.; Kaldor, J.; Vun, M.C.; Vonthanak, S.; Ruxrungtham, K.; Giaquinto, C.; Cotton, M.; Lolekha, R.; Sirisanthana, V.; Chokephaibulkit, K.; Suntarattiwong, P.; Volberding, P.; Bangdiwala, S.; Lim, K.; Samuel, N.M.; Schoenfeld, D.; Sohn, A.H.; Solomon, S.; Suwang
Aids Patient Care and Stds 27(11): 596-603
2013
ISSN/ISBN: 1557-7449 PMID: 24191673 DOI: 10.1089/apc.2013.0203Document Number: 579204
Quality of life (QOL) is an important antiretroviral treatment (ART) outcome. We compared QOL among 299 Thai and Cambodian children ages 1-12 years-old, CD4 15-24% randomized to early (ART at week 0, N=149) versus deferred groups (ART when at CD4 <15%, N=150) and also compared with QOL data from age-matched healthy controls (N=275). Primary caregivers completed PACTG QOL questionnaires at week 0 and every 24 weeks until 144 weeks. Children were enrolled during March 2006 to September 2008. Mean (SD) age of children was 6.3 (2.8) years, 58% were female, 60% were Thai, %CDC N:A:B:C was 2:62:36:0%. During 144 weeks, all children in the early-group and 69 (46%) of deferred-group children started ART. There was no significant difference of QOL scores between treatment groups at baseline (all p>0.05) and at week 144 (all p>0.05). By multivariate analysis, the early-group had higher QOL score changes in five domains, including health perception (p=0.04), physical resilience (p=0.02), psychosocial well-being (p=0.04), social and role functioning (p<0.01), and symptoms (p=0.01) compared to the deferred group. QOL of HIV-infected children in both groups were lower than healthy control in all 7 domains at baseline (all p<0.05) and 5 of 7 domains at weeks 144 (p<0.01). In conclusion, no significant difference of QOL scores between treatment groups. Early ART commencement associated with greater increase of QOL scores over 144 weeks. QOL scores in HIV-infected children were lower than healthy controls.