Wu AW, Kempen J, Martin BK, Jabs DA; International Conference on AIDS.
Int Conf AIDS. 2002 Jul 7-12; 14: abstract no. B10270.
John Hopkins University, Baltimore, United States
BACKGROUND: To evaluate the effect of cytomegalovirus (CMV) retinitis on quality of life (QOL) in AIDS. METHODS: Multi-center, cross-sectional study of patients with AIDS age >13 years enrolled at 19 US centers between 9/98 and 3/01. Patients were in three groups: Newly diagnosed CMV retinitis (median months since diagnosis=0.23)(N=50); Longstanding CMV retinitis (34.5 months since diagnosis)(N=212); and No CMV retinitis (N=709). Clinical history, CMV retinitis status by ophthalmoscopy, current CD4+ count, HIV RNA, and CMV DNA were assessed. Vision-related QOL was assessed using a CMV-retinitis specific questionnaire; general QOL using the MOS-HIV. Health utility was measured using the EuroQol which has multiattribute and Visual Analog Scale (VAS) components. Response rate for QOL data was 97%. RESULTS: For New, Longstanding and No retinitis groups, median CD4 counts were 24, 166 and 164 cells/mm3; median HIV RNA was 31,283, 1150 and 2172 c/ml, respectively. New patients were slightly younger, and more likely to be black and female. Vision-related QOL was lower in both New and Longstanding groups (e.g., visual functioning (75.6, 71.4, 82.4 p<.001). For general QOL, the New group scored lowest in VAS-measured utility (mean scores 72.5, 72.3, and 63.9 respectively, p=0.03) and many general QOL domains (e.g., physical function 57.7, 70.1, 70.1 p<.01; mental health 64.7, 71.2, 67.4 p<.01). The Longstanding and No retinitis groups were similar in most general QOL domains and utility. After multivariable adjustment for demographics, CD4+ count, HIV and CMV viral load, and current HAART, differences were attenuated but Visual and Physical Function remained significantly lower in the New retinitis group. CONCLUSIONS: Acute CMV retinitis is associated with reduced general and vision-related QOL. Patients with longstanding CMV retinitis and immune recovery regain some general functioning and well-being but deficits in vision remain.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Anti-HIV Agents
- Antiretroviral Therapy, Highly Active
- CD4 Lymphocyte Count
- Cross-Sectional Studies
- Cytomegalovirus
- Cytomegalovirus Retinitis
- Female
- HIV
- HIV Infections
- HIV Seropositivity
- Humans
- Viral Load
Other ID:
UI: 102252565
From Meeting Abstracts