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Home / The International Journal of Tuberculosis and Lung Disease, Volume 24, Number 9

The effect of TB treatment on health-related quality of life for people with advanced HIV

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BACKGROUND: Study A5274 was an open-label trial of people with HIV (PLHIV) with CD4 cell count <50 cells/µL who were randomized to empirical TB treatment vs. isoniazid preventive therapy (IPT) in addition to antiretroviral therapy (ART). We evaluated health-related quality of life (HRQoL) by study arm, changes over time, and association with sociodemographic and clinical factors.

METHODS: Participants aged >13 years were enrolled from outpatient clinics in 10 countries. HRQoL was assessed at Weeks 0, 8, 24 and 96 with questions about daily activity, hospital or emergency room visits, and general health status. We used logistic regression to examine HRQoL by arm and association with sociodemographic and clinical factors.

RESULTS: Among 850 participants (424 empiric arm, 426 IPT arm), HRQoL improved over time with no difference between arms. At baseline and Week 24, participants with WHO Stage 3 or 4 events, or those who had Grade 3 or 4 signs/symptoms, were significantly more likely to report poor HRQoL using the composite of four HRQoL measures.

CONCLUSION: HRQoL improved substantially in both arms during the study period. These findings show that ART, TB screening, and IPT can not only reduce mortality, but also improve HRQoL in PLHIV with advanced disease.

Keywords: HRQoL; IPT; advanced human immunodeficiency virus; antiretroviral therapy; tuberculosis

Document Type: Research Article

Affiliations: 1: Kenya Medical Research Institute, HIV-Research Branch, Kisumu, Kenya 2: Harvard T. H. Chan School of Public Health, Boston, MA, USA 3: Instituto Nacional de Infectologia Evandro Chagas (INI-FIOCRUZ), Rio de Janeiro, RJ, Brazil 4: University of North Carolina School of Medicine, Chapel Hill, NC, USA, University of North Carolina Project, Lilongwe, Malawi 5: Perlman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA 6: Johns Hopkins Project, Blantyre, Malawi 7: Johns Hopkins University School of Medicine, Baltimore, MD, USA 8: Joint Clinical Research Centre Clinical Research Site, Kampala, Uganda 9: Byramjee Jeejeebhoy Government Medical College Clinical Trials Unit, Pune, India 10: YR Gaitonde Centre for AIDS Research and Education, Chennai Antiviral Research and Treatment Clinical Research Site, Chennai, India 11: Centers for Disease Control and Prevention, Atlanta, GA, USA

Publication date: 01 September 2020

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  • The International Journal of Tuberculosis and Lung Disease (IJTLD) is for clinical research and epidemiological studies on lung health, including articles on TB, TB-HIV and respiratory diseases such as COVID-19, asthma, COPD, child lung health and the hazards of tobacco and air pollution. Individuals and institutes can subscribe to the IJTLD online or in print – simply email us at [email protected] for details.

    The IJTLD is dedicated to understanding lung disease and to the dissemination of knowledge leading to better lung health. To allow us to share scientific research as rapidly as possible, the IJTLD is fast-tracking the publication of certain articles as preprints prior to their publication. Read fast-track articles.

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