Brief observationAdverse effects of medications and trade-offs between length of life and quality of life in human immunodeficiency virus infection☆
Section snippets
Methods
To study health values, we developed descriptions of two hypothetical patients: one with well-controlled HIV infection and another with well-controlled HIV infection complicated by the lipodystrophy syndrome. We based the description of the HIV-infected patient on data from a U.S. population sample of HIV-infected patients (8). The description of lipodystrophy syndrome included effects on physical, social, and mental health 6, 9, 10, 11, 12, but did not include metabolic complications of the
Results
Study patients were predominantly men between 30 and 50 years of age from a variety of ethnic backgrounds (Table 1). Most were well educated, had a history of homosexual activity as a risk factor for HIV infection, and had relatively well-controlled HIV infection.
Discussion
The objective of our study was to determine whether patients with HIV disease believed that the quality-of-life effects were substantial enough to warrant trading years of life or taking a risk of death to avoid the lipodystrophy syndrome. We found most patients willing to make such trade-offs. There were important differences among patients in the length of life that they would trade and in the degree of risk that they would accept. The greatest variability among patients was observed in
Acknowledgements
We appreciated the thoughtful comments of Drs. Allen Gifford, Samuel Bozzette, and Maria E. Watson on previous versions of this manuscript.
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Cited by (56)
Association Between Body Fat Distribution Assessed by Different Techniques and Body Image Perception in HIV-Infected Children and Adolescents
2021, Journal of Pediatric NursingCitation Excerpt :Regarding the prevalence of body dissatisfaction in children and adolescents, studies show that children and adolescents showed dissatisfaction with their body image, with girls being more dissatisfied with being overweight and boys more dissatisfied with being thin (da Silva et al., 2011; Martins et al., 2019; Soares et al., 2019; Wilkins et al., 2016). Studies with HIV + individuals have shown that these patients would shorten their life expectancy or accept the increased risk of mortality in exchange for keeping their health status free from bodily changes related to lipodystrophy (Lenert et al., 2002; Soares et al., 2019; Willis et al., 2018), which demonstrates the importance of this theme for HIV + patients. Despite associations found between negative psychological consequences and asymmetric body fat distribution, there are few studies that have investigated body image and body fat distribution in HIV-infected children and adolescents (Augustemak de Lima et al., 2018; Ezekiel et al., 2009; Wilkins et al., 2016).
Lipodystrophies
2013, Revue de Medecine InterneCost-effectiveness of nucleoside reverse transcriptase inhibitor pairs in efavirenz-based regimens for treatment-nave adults with HIV infection in the United States
2011, Value in HealthCitation Excerpt :Adverse events (anemia, lipoatrophy, myocardial infarction) that impact significantly different proportions of individuals between arms of the model were modeled explicitly to capture the (differential) effects on costs, quality of life, and adherence. In addition, the model included the one-time cost for the HLA-B*5701 screening test for individuals in the ABC/3TC arm of the model and annual renal monitoring costs for individuals in the TDF/FTC arm of the model [41-45] (Table 4). The model estimated total direct medical costs, including antiretroviral drugs costs, costs for adverse events, other medical costs (including costs for disease monitoring, switching therapy lines, treating opportunistic and other infections and adverse events other than those explicitly modeled), and non-antiretroviral drug costs.
Human immunodeficiency virus and acquired immunodeficiency syndrome
2009, Hormones, Brain and Behavior OnlineFactors Correlated with Body Image Dissatisfaction in Children and Adolescents Diagnosed with HIV: A Cross-Sectional Study
2022, International Journal of Environmental Research and Public Health
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This study was funded by a grant from GlaxoSmithKline Pharmaceuticals, Brentfort, Middlesex, United Kingdom.