Perception of quality of life among HIV-infected patients after initiating treatment in Brazil

Introduction: Despite the clinical improvement of treated HIV-infected patients, the impact of antiretroviral therapy (ART) on the overall QL has become a major concern. Objective: To identify factors associated with better levels of self-reported quality of life (QL) among HIV-infected patients after four months of ART. Methods: A cross-sectional analysis was conducted with patients enrolled at two public health referral centers for AIDS, in. Patients were interviewed at baseline, i.e. before initiating ART, and one and four months later (first and second follow-up visits, respectively). QL was assessed using the WHOQOL-bref. Factors associated with good/very good QL four months after initiating ART were assessed. Logistic regression was used for analysis. Results: Overall QL was classified as ‘very good/good’ by 66.4% of the participants four months after initiating ART, while 33.6% classified their QL as ‘neither poor nor good/poor/very poor’. We observed a statistically significant improvement of overall QL comparing baseline assessment to visit two. Logistic regression indicated that ³8 years of education, none or mild symptoms of anxiety and depression, no ART switch, lower number of adverse reactions and better QL at baseline were independently associated with good/very good QL over four months of treatment. Conclusions: Our results highlight the importance of modifiable factors such as psychiatric symptoms and treatment-related variables that may contribute to a better QL among patients initiating treatment. Considering that a poor QL is related to non-adherence to ART, a careful clinical monitoring of those factors may contribute to guarantee the long-term effectiveness of antiretroviral regimens.