Health-related quality of life and physical functioning in people living with HIV/AIDS: a case–control design

Health and Quality of Life Outcomes

Christopher O Akosile⁴  Olubusola Esther Johnson¹  Yewande Ogunmoyole²  Olaniyi Onayemi³  Chidozie Emmanuel Mbada¹ 

[1] Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria;Department of Physiotherapy, Obafemi Awolowo University Teaching Hospitals Complex, Ile – Ife, Nigeria;Department of Dermatology and Veneriology, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile – Ife, Nigeria;Department of Medical Rehabilitation, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Anambra State, Nigeria

关键词: SF-12;    6MWD;    HIV/AIDS;    Functional exercise capacity;   

Others  :  823520
DOI  :  10.1186/1477-7525-11-106

 received in 2012-12-28, accepted in 2013-06-19,  发布年份 2013

【 摘 要 】

Background

Health-Related Quality of Life (HRQoL) and functional exercise capacity are important area of therapeutic interventions needed to improve the general health of People Living with HIV/AIDS (PLWH). However, the relationship between self-report and Performance-based Measure of Functional Capacity (PMFC) of PLWH is still obscure. This study compared the HRQoL and PMFC between a homogenous sample of clinical stage I PLWH and apparently healthy controls.

Methods

This case–control study involved 74 consenting participants (37 PLWH and 37 controls) who completed the self-report SF-12 questionnaire and PMFC assessment using Six Minute Walk Test (6MWT). PMFC was expressed in terms of Six-Minute Walk Distance (6MWD), Six-Minute Walk Work (6MWW) and Maximum oxygen uptake (VO₂max). Data were analyzed using descriptive statistics of mean and inferential statistics of independent t-test, ANOVA and Pearson’s product moment correlation. Alpha level was set at 0.05.

Results

There was no significant difference in the SF-12 Physical-health Component Score (PCS) of PLWH and the controls (p = 0.782). However, the SF-12 Mental-health Component Score (MCS) of PLWH was higher than that of controls (p = 0.040). 6MWD, 6MWW and VO₂max were significantly lower for PLWH (p < 0.05). Among PLWH, there was no significant gender differences in the PMFC (p > 0.05) while PCS was higher among females. There was no significant correlation between PMFC variables and each of PCS and MCS for PLWH and controls (p > 0.05) respectively.

Conclusion

Self-report physical health of clinical stage 1 PLWH and controls was comparable, while self-report mental health capacity was higher in PLWH than the controls. PMFC of PLWH was significantly lower compared to healthy controls without gender bias. Overall, self-report and performance-based measure of physical functional capacity of PLWH was not inter-related. Therefore understanding the factors that may influence exercise capacity of PLWH may help to develop effective exercise programmes for PLWH.

【 授权许可】

   
2013 Mbada et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]UNAIDS: AIDS epidemic update. 2007. http://data.unaids.org/pub/EPISlides/2007/2007_epiupdate_en.pdf webcite [Accessed 19/01/2009]
• [2]Worldwide AIDS & HIV Statistics: 2009 Quarterly HIV/AIDS statistics. AVERT. Office of AIDS; 2011. http://www.avert.org/worldstats.htm webcite. Accessed 20/06/11
• [3]World Health Organization. Global Health Observatory (GHO): Prevalence of HIV among adults aged 15–49 (%). Situation and trends. 2010. http://www.who.int/gho/hiv/epidemic_status/prevalence_text/en/index.html webcite [Accessed 22/06/2009]
• [4]UNAIDS/WHO: AIDS epidemic update. Geneva, Switzerland; 2003. Available from http://www.unaids.org/wad/2003/press/Epiupdate2003_en/Epi03_00_en.htm webcite [Accessed 21/06/2011]
• [5]UNAIDS: AIDS epidemic update: World Health Organization. Geneva: UNAIDS/07.27E/JC1322E; 2007.
• [6]UNGASS country progress report. Nigeria; 2010. http://www.unaids.org/en/regionscountries/countries/nigeria/ webcite [Accessed 22/06/2011]
• [7]Bopp CM, Phillips KD, Fulk LJ, Hand GA: Clinical implications of therapeutic exercise in HIV/AIDS. J Assoc Nurses AIDS Care 2003, 14(1):73-78.
• [8]Cushion J: HIV and AIDS research paper 95/88. House of Commons Library: Science and environment section; 1995:1-38.
• [9]Dropulic B, Humeau L, Binder GK, Lu X, Slepushkin V, Merling R, et al.: 1003. HIV-1-derived lentivirus vector-based antisense gene therapy: towards an alternative treatment for HIV/AIDS. Mol Ther 2004, 9:S384-S384.
• [10]Schambelan M, Mulligan K, Grunfeld C, Daar ES, LaMarca A, Kotler DP, Wang J, Bozzette SA, Breitmeyer JB: Recombinant human growth hormone in patients with HIV-associated wasting. A randomized, placebo-controlled trial. Serostim study group. Ann Intern Med 1996, 125(11):873-882.
• [11]Basaria S, Wahlstrom JT, Dobs AS: Clinical review 138: anabolic-androgenic steroid therapy in the treatment of chronic diseases. J Clin Endocrinol Metabol 2001, 86(11):5108-5117.
• [12]Standish LJ, Greene KB, Bain S, Reeves C, Sanders F, Wines RC, et al.: Alternative medicine use in HIV-positive men and women: demographics, utilization patterns and health status. AIDS Care 2001, 13(2):197-208.
• [13]Holzemer WL, Wilson HS: Quality of life and the spectrum of HIV infection. Annu Rev Nurs Res 1995, 13:3-29.
• [14]Wilson IB, Cleary PD: Linking clinical variables with health-related quality of life: a conceptual model of patient outcomes. JAMA 1995, 273:59-65.
• [15]Douaihy A, Singh N: Factors affecting quality of life in patients with HIV infection. AIDS Read 2001, 11(9):450-461.
• [16]O’Brien K, Nixon S, Tynan AM, Glazier RH: Effectiveness and safety of aerobic exercise in adults living with HIV/AIDS: systematic review and meta-analysis of randomized trials. Med Sci Sports Exerc 2004, 36:1659-1666.
• [17]Pothoff G, Wassermann K, Ostmann H: Impairment of exercise capacity in various groups of HIV-infected patients. Respiration 1994, 61(2):80-85.
• [18]Stringer WW, Berezovskaya M, O'Brien WA, Beck CK, Casaburi R: The effect of exercise training on aerobic fitness, immune indices, and quality of life in HIV+ patients. Med Sci Sports Exerc 1998, 30(1):11-16.
• [19]Cade WT, Fantry LE, Nabar SR, Shaw DK, Keyser RE: A comparison of Qt and a-VO2 in individuals with HIV taking and not taking HAART. Med Sci Sports Exerc 2003, 35(7):1108-1117.
• [20]Leserman J, Petitto JM, Perkins DO, Folds JD, Golden RN, Evans L: Severe stress, depressive symptoms, and changes in lymphocyte subsets in human immunodeficiency virus-infected men. A 2-year follow-up study. Arch Gen Psychiatry 1997, 54(3):279-285.
• [21]Cruess DG, Antoni MH, Schneiderman N, Ironson G, McCabe P, Fernandez JB, Cruess SE, Klimas N, Kumar M: Cognitive-behavioral stress management increases free testosterone and decreases psychological distress in HIV-seropositive men. Health Psychol 2000, 19(1):12-20.
• [22]Antoni MH, Cruess DG, Klimas N, Maher K, Cruess S, Kumar M, Lutgendorf S, Ironson G, Schneiderman N, Fletcher MA: Stress management and immune system reconstitution in symptomatic HIV-infected gay men over time: effects on transitional naive T cells (CD4(+)CD45RA(+)CD29(+)). Am J Psychiatry 2002, 159(1):143-145.
• [23]Meyer K, Görnandt L, Schwaibold M, Westbrook S, Hajric R, Peters K, Beneke R, Schnellbacher K: Predictors of response to exercise training in severe chronic congestive heart failure. HSO Am J Cardiol 1997, 80(1):56.
• [24]Nieman DC, Johanssen LM, Lee JW, Arabatzis K: Infectious episodes in runners before and after the Los Angeles Marathon. J Sports Med Phys Fitness 1990, 30(3):316-328.
• [25]Roubenoff R, Skolnik PR, Shevitz A, Snydman L, Wang A, Melanson S, Gorbach S: Effect of a single bout of acute exercise on plasma human immunodeficiency virus RNA levels. J Appl Physiol 1999, 86(4):1197-1201.
• [26]Ciccolo JT, Jowers EM, Bartholomew JB: The benefits of exercise training for quality of life in HIV/AIDS in the post-HAART Era. Sports Med 2004, 34(8):487-499.
• [27]Esposito JG, Thomas SG, Kingdon L, Ezzat S: Anabolic growth hormone action improves submaximal measures of physical performance in patients with HIV-associated wasting. Am J Physiol Endocrinol Metab 2005, 289:E494-E503.
• [28]Sterne JA, Herna´n MA, Ledergerber B, et al.: Long-term effectiveness of potent antiretroviral therapy in preventing AIDS and death: a prospective cohort study. Lancet 2005, 366:378-384.
• [29]Edwards M: The reliability and validity of self report activities of daily living. Can J Occup Ther 1990, 57(5):273-278.
• [30]Falconer J, Hughes S, Naughton B, Singer R, Chang R, Sinacore J: Self report and performance-based hand function tests as correlates of dependency in the elderly. J Am Ger Soc 1991, 39:695-699.
• [31]Matheson L, Matheson M, Grant J: Development of a measure of perceived functional ability. J Occup Rehabil 1993, 3(1):15-30.
• [32]Kuhn R, Rahman O, Menken J: Survey Measures of Health: How Well do self-reported and observed indicators measures health and Predict Mortality? Chapter 10. In Barney Cohen and Jane Menken aging in Sub-Saharan Africa: Recommendation for furthering research.. Research Council (US) Committee on Population: National Academies Press (US); 2006:314-342.
• [33]Dorevitch MI, Cossar RM, Bailey FJ, et al.: The accuracy of self and informant ratings of physical functional capacity in the elderly. J Clin Epidemiol 1992, 45:791-798.
• [34]Myers AM, Holliday PJ, Harvey A, et al.: Functional performance measures: are they superior to self-assessment? J Gerontol A Biol Sci Med Sci 1993, 48:M196-M206.
• [35]Kuijer W, Gerrits EHJ, Reneman MF: Measuring physical performance via self-report in healthy young adults. J Occup Rehabil 2004, 14(1):77-87.
• [36]Centers for Disease Control and Prevention (CDC): Revised classification system for HIV infection and expanded surveillance case definition for AIDS among adolescents and adults. MMWR Recomm Rep 1993, 18;41:1-19.
• [37]World Health Organization: WHO case definitions of HIV for surveillance and revised clinical staging and immunological classification of HIV-related disease in adults and children. 2007. http://www.who.int/hiv/pub/guidelines/HIVstaging150307.pdf webcite [Accessed 22/06/2011]
• [38]Delate T, Coons SJ: The discriminative ability of the 12-Item short form health survey (SF-12) in a sample of persons infected with HIV. Clin Ther 2001, 22(9):1112-1120.
• [39]Lam CL, Tse EY, Gandek B: Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual Life Res 2005, 14(2):539-547.
• [40]Montazeri A, Vahdaninia M, Mousavi SJ, Asadi-Lari M, Omidvari S, Tavousi M: Health Qual Life Outcomes. 2011, 7;9:1.
• [41]Han C, Pulling CC, Telke SE, Huppler Hullsiek K: Terry Beirn Community Programs for Clinical Research on AIDS. Assessing the utility of five domains in SF-12 Health Status Questionnaire in an AIDS clinical trial. AIDS 2002, 15;16(3):431-439.
• [42]Grossman HA, Sullivan PS, Wu AW: Quality of life and HIV: Current Assessment Tools and Future Directions for Clinical Practice. AIDS Read 2003, 13(12):583-597.
• [43]American Thoracic Society Statement (ATS): Guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002, 166:111-117.
• [44]Chuang ML, Lin IF, Wasserman K: The body weight-walking distance product as related to lung function, anaerobic threshold and peak VO2 in COPD patients. Respir Med 2001, 95:618-626.
• [45]American College of Sport Medicine (ACSM): Guidelines for Graded exercise testing and exercise prescription. 5th edition. Philadelphia (PA): Lea & Febiger; 1995:172-175.
• [46]Franchi D, Wenzel RP: Measuring health-related quality of life among patients infected with human immunodeficiency virus. Clin Infect Dis 1998, 26:20-26.
• [47]Marins JR, Jamal LF, Chen SY, Barros MB, Hudes ES, Barbosa AA: Dramatic improvement in survival among adult Brazilian AIDS patients. AIDS 2003, 17:1675-1682.
• [48]Nojomi M, Anbary K, Ranjbar M: Health-related quality of life in patients with HIV/AIDS. Arch Iran Med 2008, 11(6):608-612.
• [49]Nirmal B, Divya KR, Dorairaj VS, Venkateswaran K: Quality of life in HIV/AIDS patients: A cross-sectional study in south India. Indian Journal of Sexually transmitted diseases and AIDS 2008, 29(1):15-17.
• [50]Moyle G: Clinical manifestations and management of antiretroviral nucleoside analog-related mitochondrial toxicity. Clin Ther 2000, 22:911-936.
• [51]Rabkin JG, Johnson J, Lin SH, Lipsitz JD, Remien RH, Williams JB, Gorman JM: Psychopathology in male and female HIV-positive and negative injecting drug users: longitudinal course over 3 years. AIDS 1997, 15;11(4):507-515.
• [52]Nokes KM, Kendrew J: Correlates of sleep quality in persons with HIV disease. J Assoc Nurses AIDS Care 2001, 12(1):17-22.
• [53]Turner BJ, Laine C, Cosler L, Hauck WW: Relationship of gender, depression, and health care delivery with antiretroviral adherence in HIV-infected drug users. J Gen Intern Med 2003, 18:248-257.
• [54]Aranda-Naranjo B: Quality of life in the HIV-positive patient: implications and consequences. J Assoc Nurses AIDS Care 2004, 15(5 Suppl):20S-27S.
• [55]Ostrow D, Liu C, Detels R, Hu Z, Johnson C, Kingsley L, Jacobson LP: Impact of HIV infection & HAART use on quality of life. Qual Life Res 2006, 15:941-949.
• [56]Adewuya A, Makanjuola R: Preferred treatment for mental illness among southwestern Nigerians. Psychiatr Serv 2009, 60(1):121-124.
• [57]Pargament KI, McCarthy S, Shah P, Ano G, Tarakeshwar N, Wachholtz A, Sirrine N, Vasconcelles E, Murray-Swank N, Locher A, Duggan J: Religion and HIV: a review of the literature and clinical implications. South Med J 2004, 97(12):1201-9.
• [58]Oyebola FO: A Case Study from Nigeria: The added value of spiritual care and support in a terminally ill-patient and family. J Palliat Medhttp://www.palliativejournal.stanford.edu/?p=3623 webcite Accessed on 06/08/2012
• [59]Tsevat J: Spirituality/Religion and Quality of Life in Patients with HIV/AIDS. J Gen Intern Med 2006, 21(S5):S1-S2.
• [60]Tsevat J, Sherman SN, McElwee JA, Mandell KL, Simbartl LA, Sonnenberg FA, Fowler FJ Jr: The will to live among HIV-infected patients. Ann Intern Med 1999, 3;131(3):194-8.
• [61]Sowell R, Moneyham L, Hennessy M, Guillory J, Demi A, Seals B: Spiritual activities as a resistance resource for women with human immunodeficiency virus. Nurs Res 2000, 49:73-82.
• [62]Grimsley LP: Spirituality and quality of life in HIV-positive persons. J Cult Divers 2006, 13:113-8.
• [63]Cotton S, Puchalski CM, Sherman SN, Mrus JM, Peterman AH, Feinberg J, Pargament KI, Justice AC, Leonard AC, Tsevat J: Spirituality and religion in patients with HIV/AIDS. J Gen Intern Med 2006, 21(Suppl 5):S5-13.
• [64]Hall BA: Patterns of spirituality in persons with advanced HIV disease. Res Nurs Health 1998, 21:143-53.
• [65]Siegel K, Schrimshaw EW: The perceived benefits of religious and spiritual coping among older adults living with HIV/AIDS. Journal for the Scientific Study of Religion 2002, 41:91-102.
• [66]Somlai AM, Heckman TG: Correlates of spirituality and well-being in a community sample of people living with HIV disease. Mental Health, Religion and Culture 2000, 3:57-70.
• [67]Tuck I, McCain NL, Elswick RK Jr: Spirituality and psychosocial factors in persons living with HIV. J Adv Nurs 2001, 33:776-83.
• [68]Dourado VZ: Reference Equations for the 6-Minute Walk Test in Healthy Individuals. Arq Bras Cardiol 2011, 96:6:e128-138.
• [69]Cade WT, Peralta L, Keyser RE: Aerobic capacity in late adolescents infected with HIV and controls. Pediatr Rehabil 2002, 5(3):161-9.
• [70]Cade WT, Fantry LE, Nabar SR, Keyser RE: Decreased peak arteriovenous oxygen difference during treadmill exercise testing in individuals infected with the human immunodeficiency virus. Arch Phys Med Rehabil 2003, 84(11):1595-603.
• [71]Carter R, Holiday DB, Nwasuruba C, Stocks J, Grothues C, Tiep B: 6-minute walk work for assessment of functional capacity in patients with COPD. Chest 2003, 123(5):1408-1415.
• [72]Hill K, Jenkins SC, Cecins N, Philippe DL, Hillman DR, Eastwood PR: Estimating maximum work rate during incremental cycle ergometry testing from six-minute walk distance in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2008, 89:1782-1787.
• [73]Rogea BT, Calbetb JAL, Mollera K, Ulluma H, Hendelc HW, Gerstofta J, Pedersena BK: Skeletal muscle mitochondrial function and exercise capacity in HIV-infected patients with lipodystrophy and elevated p-lactate levels. AIDS 2002, 16:973-982.
• [74]Holzemer WL, Gygax Spicer J, Skodol Wilson H, Kemppainen JK, Coleman C: Validation of the quality of life scale: living with HIV. J Adv Nurs 1998, 28(3):622-30.
• [75]O'Keefe EA, Wood R: The impact of human immunodeficiency virus (HIV) infection on quality of life in a multiracial South African population. Qual Life Res 1996, 5(2):275-80.
• [76]Vidrine DJ, Amick BC 3rd, Gritz ER, Arduino RC: Functional status and overall quality of life in a multiethnic HIV-positive population. AIDS Patient Care STDS 2003, 17(4):187-97.
• [77]Laura R, Patrick D, Patrick M, Frédéric-Antoine D, Mathias B, Carinec G, François D, Fabrice B, Geneviève C, For the Groupe d'Epidémiologie Clinique du SIDA en Aquitaine (GECSA): High frequency of poor locomotor performance in HIV-infected patients. AIDS 2011, 25(6):797-805.
• [78]Scruggs ER, Dirks Naylor AJ: Mechanisms of zidovudine-induced mitochondrial toxicity and myopathy. Pharmacology 2008, 82:83-88.
• [79]Wekesa E: The impact of HIV/AIDS on child survival and development in Kenya. AIDS Anal Af 2000, 10:12-14.
• [80]Catz SL, Gore-Felton C, McClure JB: Psychological distress among minority and low-income women living with HIV. Behav Med 2002, 28:53-60.