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Health-Related Quality of Life in People Living With HIV With Cognitive Symptoms: Assessing Relevant Domains and
Kate Alford1, Sube Banerjee2, Stephanie Daley3
1Department of Global Health and Infection, 12190Brighton and Sussex Medical School, Brighton, UK.
Insights
People living with HIV (PLWH) experiencing cognitive symptoms often have poor health-related quality of life (HRQL). This study identified key HRQL domains, offering targets for interventions to improve well-being in this population.
Area of Science:
- Neuroscience
- Public Health
- Psychology
Background:
- Cognitive symptoms are prevalent in people living with HIV (PLWH).
- Health-related quality of life (HRQL) is a critical outcome in managing chronic conditions like HIV.
- Existing HRQL measures may not fully capture the experiences of PLWH with cognitive symptoms.
Purpose of the Study:
- To validate and assess illness-specific HRQL domains in PLWH with cognitive symptoms.
- To identify specific HRQL domains that are significantly impacted in this population.
- To provide data for developing targeted interventions to improve HRQL.
Main Methods:
- A cohort of 103 PLWH with cognitive symptoms from UK HIV clinics participated.
- Validated scales were used to measure seven key HRQL domains.
- Exploratory factor analysis and scale cut-off scores were employed for analysis.
Main Results:
- Exploratory factor analysis confirmed a single main factor representing overall HRQL.
- A significant proportion of patients scored outside normal ranges on single (26.2%-79.6%) and multiple domains (40.8% on 4+).
- The majority of PLWH with cognitive symptoms demonstrated poor HRQL across identified domains.
Conclusions:
- Poor HRQL is widespread among PLWH with cognitive symptoms.
- Specific HRQL domains identified serve as crucial targets for clinical intervention.
- Improving HRQL in PLWH with cognitive impairment requires focused strategies addressing these domains.
Abstract:
This study aimed to validate and assess a comprehensive set of illness-specific health-related quality of life (HRQL) domains in people living with HIV (PLWH) with cognitive symptoms. One hundred and three HIV patients with cognitive symptoms (n = 93 male, 90.3%) were identified from two UK HIV clinics and complete a series of validated scales measuring seven HRQL domains identified as important to HRQL by PLWH with cognitive impairment. These included: physical functioning, cognition, social connectedness, self-concept, HIV stigma, acceptance of and perceived control over cognitive health, and physical and mental health and wellbeing. Exploratory factor analysis confirmed that domain total scores loaded onto one main factor, representing HRQL. Scale cut-off scores revealed a significant proportion of patients scored outside the normal range on single domains (between 26.2% and 79.6%), and many patients on multiple domains (40.8% on 4 or more domains). We found evidence of poor HRQL across domains in the majority of PLWH with cognitive symptoms and identified domains driving these experiences. This provides targets for intervention development and clinical action to maintain or improve HRQL in PLWH with cognitive symptoms or impairment.
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