8th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV San Francisco, California - September 24 - 26, 2006

THE IMPACT OF HIV-ASSOCIATED ADIPOSE REDISTRIBUTION SYNDROME (HARS) ON HEALTH-RELATED QUALITY OF LIFE

Antiviral Therapy 2006; 11:L25 (abstract no. 36)

RR Turner¹, MA Testa², M Su¹, G Richmond³, N Muurahainen⁴, DP Kotler⁵ and M Thompson^6
1Phase V Technologies, Wellesley, MA, USA; ²Harvard School of Public Health, Boston, MA, USA; ³Fort Lauderdale, FL, USA; ⁴Serono Inc., Rockland, MA, USA; ⁵Columbia University St. Lukes-Roosevelt Medical Center, New York, NY, USA; ⁶AIDS Research Consortium of Atlanta (ARCA), Atlanta, GA, USA

BACKGROUND: HARS, a condition defined by excess truncal/visceral fat in HIV patients (pts), results in significant body dysmorphia and impaired health-related quality of life (HRQOL). To describe the comparative impact of HARS on HRQOL, data from HARS pts were compared to that of pts with three other chronic diseases.

METHODS: Pts in clinical trials with HARS (n=480) and without HIV but hypertension (HTN; n=354), type 1 diabetes (DM1, n=594) or type 2 diabetes (DM2, n=1019) completed standardized Phase V Outcomes Information System scales at baseline to assess general perceived health (GPH), psychological well being (PWB), psychological distress (PD), and summary HRQOL.

RESULTS: HARS pts (44.7 ±7.2 years) were significantly older than DM1 (38.3 ±10.7) but younger than DM2 (57.5 ±10.1) and HTN (54.9 ±11.4) (P<0.01). HARS pts also had proportionally more males (86% versus 54%, 65%, and 44%; P<0.01). Controlling for age and sex, HARS pts had significantly lower (worse) GPH scores (general health status, sleep disturbance, vitality, composite score; P<0.013). PD scores in HARS were lower (worse) than in DM but not in HTN (anxiety, behavioral control, depression, composite; P<0.001). PWB was also worse with respect to emotional ties (P<0.001) and general positive affect (P<0.003) in HARS than in the other pts, but lower only than DM for life satisfaction and composite well-being (P<0.001). Summary HRQOL scores were significantly lower in HARS than all other pts (P<0.001). The average adjusted effect size across all comparisons was 0.351.

CONCLUSION: HARS substantially impacts several important HRQOL domains, as compared to 3 other chronic diseases. HARS has important consequences, especially for perceived health and mental and emotional functioning, which need to be considered as part of the treatment plan.

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2006-09-24
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