Patient reported symptoms improve following prolonged treatment interruption: ACTG 5170 quality of life results
Objectives: To assess quality of life (QOL) in healthy HIV+ patients who underwent antiretroviral therapy (ART) treatment interruption (TI).
Methods: We assessed QOL in patients who voluntarily underwent TI in ACTG 5170, a multicenter, prospective study. Major entry criteria were pre-ART and entry CD4 count >350 cells/mm3, entry HIV RNA <55,000 copies/mL, and on ART for ³ 6 months. QOL was assessed at baseline, weeks 24, 48, 72 and 96 by patient self-report (0-100 scale), by patient reported symptoms distress module, and by the multidimensional health status tool (MHS). Wilcoxon Signed Rank test was used in data analysis to compare QOL and symptoms on ART (baseline) to during TI within subjects.
Results: 167 subjects enrolled with median baseline and nadir CD4 count of 833 and 436 cells/mm3, respectively, and median time on ART 4.5 years. Following TI, mean number of symptoms decreased from 8.2 at baseline to 7.0 at week 96, p = 0.005. The mean number of bothersome symptoms (³ 3 on scale 0-4) also decreased at weeks 24 and 48 compared to baseline, p= 0.033, 0.044, respectively. The overall symptom summary score decreased from baseline to week 96, p = 0.039. The symptoms most frequently reported during TI were fatigue, feeling sad, difficulty falling asleep and trouble remembering. There were no significant changes from baseline in the MHS mental or physical domain scores. Self-reported QOL score remained high although there was a weak trend for decreasing QOL after TI (median 90 at baseline vs 85 at week 96), p = 0.089. There was no difference in QOL outcomes when the analysis was restricted to patients who remained on study through week 96.
Conclusions: In this cohort of individuals with preserved immune function, who underwent a prolonged TI, patient reported symptoms improved, while subjective QOL remained high.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
"SkiestD., et al.
Patient reported symptoms improve following prolonged treatment interruption: ACTG 5170 quality of life results.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention: