Brief observation
Adverse effects of medications and trade-offs between length of life and quality of life in human immunodeficiency virus infection

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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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References (18)

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This study was funded by a grant from GlaxoSmithKline Pharmaceuticals, Brentfort, Middlesex, United Kingdom.

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