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- Article] Effect of Treatment Interruption and Intensification of Antiretroviral Therapy on Health-Related Quality of Life in Patients with Advanced HIV: A Randomized, Controlled Trial
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DocNo of ILP: 1627
Doc. Type: Article
Title: Effect of Treatment Interruption and Intensification of Antiretroviral Therapy on Health-Related Quality of Life in Patients with Advanced HIV: A Randomized, Controlled Trial
Authors: Joyce, VR; Barnett, PG; Chow, A; Bayoumi, AM; Griffin, SC; Sun, HY; Holodniy, M; Brown, ST; Kyriakides, TC; Cameron, DW; Youle, M; Sculpher, M; Anis, AH; Owens, DK
Full Name of Authors: Joyce, Vilija R.; Barnett, Paul G.; Chow, Adam; Bayoumi, Ahmed M.; Griffin, Susan C.; Sun, Huiying; Holodniy, Mark; Brown, Sheldon T.; Kyriakides, Tassos C.; Cameron, D. William; Youle, Mike; Sculpher, Mark; Anis, Aslam H.; Owens, Douglas K.
Keywords by Author: AIDS; HIV; highly active antiretroviral therapy; quality of life; treatment interruption; treatment intensification; randomized trial
Keywords Plus: HUMAN-IMMUNODEFICIENCY-VIRUS; CD4 CELL COUNTS; STRUCTURED TREATMENT INTERRUPTIONS; INFECTED PATIENTS; HIV-1-INFECTED PATIENTS; DRUG-RESISTANCE; VIROLOGICAL FAILURE; CUBIC MILLIMETER; UTILITY SCORES; CLINICAL-TRIAL
Abstract: Background. The effect of antiretroviral therapy (ART) interruption or intensification on health-related quality of life (HRQoL) in advanced HIV patients is unknown. Objective. To assess the impact of temporary treatment interruption and intensification of ART on HRQoL. Design. A 2 x 2 factorial open label randomized controlled trial. Setting. Hospitals in the United States, Canada, and the United Kingdom. Patients. Multidrug resistant (MDR) HIV patients. Intervention. Patients were randomized to receive a 12-wk interruption or not, and ART intensification or standard ART. Measurements. The Health Utilities Index (HUI3), EQ-5D, standard gamble (SG), time tradeoff (TTO), visual analog scale (VAS), and the Medical Outcomes Study HIV Health Survey (MOS-HIV). Results. There were no significant differences in HRQoL among the four groups during follow-up; however, there was a temporary significant decline in HRQoL on some measures within the interruption group during interruption (HUI3 -0.05, P = 0.03; VAS -5.9, P = 0.002; physical health summary -2.9, P = 0.001; mental health summary -1.9, P = 0.02). Scores declined slightly overall during follow-up. Multivariate analysis showed significantly lower HRQoL associated with some clinical events. Limitations. The results may not apply to HIV patients who have not experienced multiple treatment failures or who have not developed MDR HIV. Conclusions. Temporary ART interruption and ART intensification provided neither superior nor inferior HRQoL compared with no interruption and standard ART. Among surviving patients, HRQoL scores declined only slightly over years of follow-up in this advanced HIV cohort; however, approximately one-third of patients died during the trial follow up. Lower HRQoL was associated with adverse clinical events.
Cate of OECD: Health sciences
Year of Publication: 2012
Business Area: other
Detail Business: medicine & science
Country: USA
Study Area:
Name of Journal: MEDICAL DECISION MAKING
Language: English
Country of Authors: [Joyce, Vilija R.; Barnett, Paul G.; Chow, Adam] VA Palo Alto Hlth Care Syst, VA Cooperat Studies Program Coordinating Ctr, VA HSR&D Hlth Econ Resource Ctr, Menlo Pk, CA 94025 USA; [Bayoumi, Ahmed M.] St Michaels Hosp, Li Ka Shing Knowledge Inst, Keenan Res Ctr, Ctr Res Inner City Hlth, Toronto, ON M5B 1W8, Canada; [Bayoumi, Ahmed M.] St Michaels Hosp, Div Gen Internal Med, Toronto, ON M5B 1W8, Canada; [Bayoumi, Ahmed M.] Univ Toronto, Dept Med, Toronto, ON M5S 1A1, Canada; [Bayoumi, Ahmed M.] Univ Toronto, Dept Hlth Policy Management & Evaluat, Toronto, ON M5S 1A1, Canada; [Griffin, Susan C.; Sculpher, Mark] Univ York, Ctr Hlth Econ, York YO10 5DD, N Yorkshire, England; [Sun, Huiying] St Pauls Hosp, Ctr Hlth Evaluat & Outcome Sci, Vancouver, BC V6Z 1Y6, Canada; [Sun, Huiying; Anis, Aslam H.] Canadian HIV Trials Network, Vancouver, BC, Canada; [Holodniy, Mark; Owens, Douglas K.] VA Palo Alto Hlth Care Syst, Palo Alto, CA USA; [Brown, Sheldon T.] James J Peters VA Med Ctr, Bronx, NY USA; [Kyriakides, Tassos C.] VA Cooperat Studies Program Coordinating Ctr, West Haven, CT USA; [Cameron, D. William] Univ Ottawa, Ottawa Hosp Res Inst, Div Infect Dis, Ottawa, ON, Canada; [Youle, Mike] Royal Free Hosp, London NW3 2QG, England; [Anis, Aslam H.] Univ British Columbia, Dept Hlth Care & Epidemiol, Vancouver, BC V6T 1W5, Canada; [Owens, Douglas K.] Stanford Univ, Ctr Primary Care & Outcomes Res, Stanford, CA 94305 USA
Press Adress: Joyce, VR (reprint author), VA Palo Alto Hlth Care Syst, Hlth Econ Resource Ctr, 795 Willow Rd,152 MPD, Menlo Pk, CA 94025 USA.
Email Address: vilija.joyce@va.gov
Citaion: Joyce, Vilija/0000-0002-2484-4625
Funding: Ontario HIV Treatment Network, Ontario Ministry of Health; Department of Veterans Affairs; Veterans Health Administration; Office of Research and Development; UK Medical Research Council; Canadian Institutes for Health Research; United Kingdom Medical Research Council
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Number of Citaion: 50
Publication: SAGE PUBLICATIONS INC
City of Publication: THOUSAND OAKS
Address of Publication: 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
ISSN: 0272-989X
29-Character Source Abbreviation: MED DECIS MAKING
ISO Source Abbreviation: Med. Decis. Mak.
Volume: 32
Version: 1
Start of File: 70
End of File: 82
DOI: 10.1177/0272989X10397615
Number of Pages: 13
Web of Science Category: Health Care Sciences & Services; Medical Informatics
Subject Category: Health Care Sciences & Services; Medical Informatics
Document Delivery Number: 884JN
Unique Article Identifier: WOS:000299701100011
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