TY - JOUR

T1 - Estimation of Health-State Utility Values and Factors Driving Health-Related Quality of Life in People Living with HIV and AIDS and Receiving cART in Germany

T2 - Baseline Analysis of a Cohort Study

AU - Treskova, Martina

AU - Scholz, Stefan

AU - Kuhlmann, Alexander

AU - Mahlich, Jörg

AU - Stoll, Matthias

N1 - Funding Information: The conducted survey resulted from valuable contributions made by a great team of medical professionals. We thank our colleagues, Martin Hower, Claudia Bachmann, Hans Heiken, Stephan Klauke, Johannes Bogner, Olaf Degen, Hans-J?rgen Stellbrink, Ingrid Leistner, Christian Tr?der, Birger Kuhlmann, Reinhold E. Schmidt, Stefan Reuter, Peter Gute, Dietrich Gorriahn, Britta Ranneberg and J?rn Wettach who greatly assisted the processes of patients? enrolment and data collection. The authors thank all patients and the study centers for participating in the CORSAR survey: ID-Ambulanz der Medizinischen Klinik Nord, Klinikum Dortmund, Dortmund. Innere Medizin, Praxis Georgstraße, Hannover. Infektiologie, Infektiologikum, Frankfurt. Infektionskrankheiten und klinische Immunologie, Ludwig-Maximilians-Universität München, München. Infektiologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg. ICH Grindelstraße, Infektionsmedizinisches Centrum Hamburg, Hamburg. Innere Medizin, Ärzteforum Seestraße, Berlin. Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Hannover Please contact author for data requests.

PY - 2022/4

Y1 - 2022/4

N2 - HIV has become a chronic disease since widespread of combined antiretroviral therapy (cART). Understanding the influence of therapeutic and preventive interventions on health-related quality of life (HRQoL) of people living with HIV and AIDS (PLWHA) is important. Information about health state utilities and HRQoL in PLWHA after the introduction of cART is limited, especially in Germany. The study aims to estimate and describe health state utilities and HRQoL in PLWHA in Germany and explore the effects of patient characteristics, clinical and treatment factors. Utilities and HRQoL in PLWHA in Germany were measured with the generic EQ-5D-3L questionnaire. Health state utilities were calculated based on the EQ-5D descriptive system using the German EQ-5D-3L time trade-off (TTO) value set. HRQoL was calculated based on the EQ visual analogue scale (EQ-VAS). Extensive descriptive analyses were performed to represent utility values for different groups of the patients. Generalized linear models (GLMs) with beta-inflated distributions were used to determine patient characteristics and clinical factors that influence TTO utilities and VAS scores. 1056 PLWHA completed the EQ-5D-3L questionnaires at the beginning of the study. The mean TTO utility value is 0.912 (SD ± 0.154), and the mean VAS HRQoL is 84.32 (SD ± 18.55). “Anxiety/depression” and “pain/physical discomfort” are the most affected dimensions. A longer period of living with HIV, a lower CD4-cell count, having symptomatic HIV or AIDS and an increased number of changes in therapy are associated with decreased utilities and a lower probability of having HRQoL of perfect health. No significant effect of duration of regimen was found. Depression significantly decreases TTO utility values. Higher education, full-time employment and female gender are associated with higher utilities. The resulted EQ-VAS values for PLWHA in Germany are comparable with EQ-VAS estimates for the general population. The obtained estimates can be used as inputs for health economic evaluations of HIV-interventions. Addressing anxiety and depression may reduce the quality of life impairment in PLWHA. Impact of comorbidities needs further investigation.

AB - HIV has become a chronic disease since widespread of combined antiretroviral therapy (cART). Understanding the influence of therapeutic and preventive interventions on health-related quality of life (HRQoL) of people living with HIV and AIDS (PLWHA) is important. Information about health state utilities and HRQoL in PLWHA after the introduction of cART is limited, especially in Germany. The study aims to estimate and describe health state utilities and HRQoL in PLWHA in Germany and explore the effects of patient characteristics, clinical and treatment factors. Utilities and HRQoL in PLWHA in Germany were measured with the generic EQ-5D-3L questionnaire. Health state utilities were calculated based on the EQ-5D descriptive system using the German EQ-5D-3L time trade-off (TTO) value set. HRQoL was calculated based on the EQ visual analogue scale (EQ-VAS). Extensive descriptive analyses were performed to represent utility values for different groups of the patients. Generalized linear models (GLMs) with beta-inflated distributions were used to determine patient characteristics and clinical factors that influence TTO utilities and VAS scores. 1056 PLWHA completed the EQ-5D-3L questionnaires at the beginning of the study. The mean TTO utility value is 0.912 (SD ± 0.154), and the mean VAS HRQoL is 84.32 (SD ± 18.55). “Anxiety/depression” and “pain/physical discomfort” are the most affected dimensions. A longer period of living with HIV, a lower CD4-cell count, having symptomatic HIV or AIDS and an increased number of changes in therapy are associated with decreased utilities and a lower probability of having HRQoL of perfect health. No significant effect of duration of regimen was found. Depression significantly decreases TTO utility values. Higher education, full-time employment and female gender are associated with higher utilities. The resulted EQ-VAS values for PLWHA in Germany are comparable with EQ-VAS estimates for the general population. The obtained estimates can be used as inputs for health economic evaluations of HIV-interventions. Addressing anxiety and depression may reduce the quality of life impairment in PLWHA. Impact of comorbidities needs further investigation.

KW - Determinants of HRQoL

KW - EQ VAS

KW - EQ-5D

KW - Germany

KW - HIV

KW - PLWHA

KW - Quality of life

KW - TTO

UR - http://www.scopus.com/inward/record.url?scp=85103386483&partnerID=8YFLogxK

U2 - 10.1007/s11482-021-09939-1

DO - 10.1007/s11482-021-09939-1

M3 - Article

AN - SCOPUS:85103386483

VL - 17

SP - 851

EP - 869

JO - Applied Research in Quality of Life

JF - Applied Research in Quality of Life

SN - 1871-2584

IS - 2

ER -