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dc.contributor.authorMutabazi Mwesigire, Doris
dc.contributor.authorWu, Albert W.
dc.contributor.authorMartin, Faith
dc.contributor.authorKatamba, Achilles
dc.contributor.authorSeeley, Janet
dc.date.accessioned2021-12-20T19:13:25Z
dc.date.available2021-12-20T19:13:25Z
dc.date.issued2015
dc.identifier.citationMwesigire, D. M., Wu, A. W., Martin, F., Katamba, A., & Seeley, J. (2015). Quality of life in patients treated with first-line antiretroviral therapy containing nevirapine or efavirenz in Uganda: a prospective non-randomized study. BMC health services research, 15(1), 1-11.en_US
dc.identifier.uri10.1186/s12913-015-0959-0
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/862
dc.description.abstractThe goal of antiretroviral therapy (ART) is to suppress viral replication, reduce morbidity and mortality, and improve quality of life (QoL). For resource-limited settings, the World Health Organization recommends a first-line regimen of two-nucleoside reverse-transcriptase inhibitors and one non-nucleoside transcriptase inhibitor (nevirapine (NVP) or efavirenz (EFV)). There are few data comparing the QoL impact of NVP versus EFV. This study assessed the change in QoL and factors associated with QoL among HIV patients receiving ART regimens based on EFV or NVP. We enrolled 640 people with HIV eligible for ART who received regimens including either NVP or EFV. QoL was assessed at baseline, three months and six months using Physical Health Summary (PHS) and Mental Health Summary (MHS) scores and the Global Person Generated Index (GPGI). Data were analyzed using generalized estimating equations, with ART regimen as the primary exposure, to identify associations between patient and disease factors and QoL. QoL increased on ART. The mean QoL scores did not differ significantly for regimens based on NVP versus EFV during follow-up for MHS and GPGI regardless of CD4 stratum and for PHS among patients with a CD4 count >250 cells/μL. The PHS-adjusted β coefficients for ART regimens based on EFV versus NVP by CD4 count strata were as follows: −1.61 (95 % CI −2.74, −0.49) for CD4 count 250 cells/μL. The corresponding MHS-adjusted β coefficients were as follows: −0.39 (−1.40, 0.62) for CD4 < 100 cells/μL; 0.16 (−0.66, 0.98) for CD4 count 101–250 cells/μL; and −0.75 (−2.01, 0.51) for CD4 count >250 cells/μL. The GPGI-adjusted odds ratios for EFV versus NVP were 0.51 (0.25, 1.04) for CD4 count 250 cells/μL. QoL improved among patients on EFV over the 6-month follow-up period (MHS p < 0.001; PHS p = 0.04, p = 0.028). Overall, patients with depression (PHS p < 0.001; GPGI p < 0.001) had lower scores and women had lower MHS (on NVP, p = 0.001). Other factors associated with lower QoL included alcohol use, low education level and advanced HIV disease. Conclusions: ART improves QoL. The results support use of either NVP or EFV. Patients initiating ART should be assessed for depression and managed appropriately. Women may require extra support to improve their QoL.en_US
dc.language.isoenen_US
dc.publisherBMC health services researchen_US
dc.subjectQuality of lifeen_US
dc.subjectHIV/AIDSen_US
dc.subjectEfavirenzen_US
dc.subjectNevirapineen_US
dc.titleQuality of life in patients treated with first-line antiretroviral therapy containing nevirapine or efavirenz in Uganda: a prospective non-randomized studyen_US
dc.typeArticleen_US


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