Poor quality of life among untreated Thai and Cambodian children without severe HIV symptoms

There are limited data on quality of life (QOL) 1 in untreated HIV-infected children who do not have severe HIV symptoms. Moreover, such data do not exist for Asian children. Poor QOL could be a factor in deciding if antiretroviral therapy (ART) should be initiated. Thai and Cambodian children (n=29...

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Published in:	AIDS care Vol. 24; no. 1; pp. 30 - 38
Main Authors:	Bunupuradah, Torsak, Puthanakit, Thanyawee, Kosalaraksa, Pope, Kerr, Stephen J., Kariminia, Azar, Hansudewechakul, Rawiwan, Kanjanavanit, Suparat, Ngampiyaskul, Chaiwat, Wongsawat, Jurai, Luesomboon, Wicharn, Chuenyam, Theshinee, Vonthanak, Saphonn, Vun, Mean Chhi, Vibol, Ung, Vannary, Bun, Ruxrungtham, Kiat, Ananworanich, Jintanat, on behalf of the PREDICT study group
Format:	Journal Article
Language:	English
Published:	Abingdon Taylor & Francis Group 01-01-2012 Taylor & Francis Taylor & Francis Ltd
Subjects:	AIDS/HIV Antiretroviral drugs Antiretroviral therapy ART-naïve Asian Asians Biological and medical sciences Cambodia CD4 Lymphocyte Count Child Child, Preschool Children Childrens health Drug therapy Female Health Health care HIV HIV Infections - physiopathology HIV Infections - psychology Human immunodeficiency virus Human viral diseases Humans Immune response system Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infant Infectious diseases Male Medical sciences Medical treatment Public health Quality of Life Surveys and Questionnaires Symptoms Thailand Untreated Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids World Health Organization Cambodia Thailand Human Immunopathology Art Asiatic Retroviridae AIDS ART-naive Immune deficiency Lentivirus Asian Ethnic group Quality of life Infection Virus Symptomatology HIV children Viral disease Human immunodeficiency virus Child
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Summary:	There are limited data on quality of life (QOL) 1 in untreated HIV-infected children who do not have severe HIV symptoms. Moreover, such data do not exist for Asian children. Poor QOL could be a factor in deciding if antiretroviral therapy (ART) should be initiated. Thai and Cambodian children (n=294), aged 1-11 years, naïve to ART, with mild to moderate HIV symptoms and CD4 15-24% were enrolled. Their caregivers completed the Pediatric AIDS Clinical Trials Group QOL questionnaire prior to ART commencement. Six QOL domains were assessed using transformed scores that ranged from 0 to 100. Higher QOL scores indicated better health. Mean age was 6.1 (SD 2.8) years, mean CD4 was 723 (SD 369) cells/mm 3 , 57% was female, and%CDC N:A:B was 2:63:35%. One-third knew their HIV diagnosis. Mean (SD) scores were 69.9 (17.6) for health perception, 64.5 (16.2) for physical resilience, 84.2 (15.6) for physical functioning, 77.9 (16.3) for psychosocial well-being, 74.7 (28.7) for social and role functioning, 90.0 (12.1) for health care utilization, and 87.4 (11.3) for symptoms domains. Children with CD4 counts above the 2008 World Health Organization (WHO) ART-initiation criteria (n=53) had higher scores in health perception and health care utilization than those with lower CD4 values. Younger children had poorer QOL than older children despite having similar mean CD4%. In conclusion, untreated Asian children without severe HIV symptoms had relatively low QOL scores compared to published reports in Western countries. Therapy initiation criteria by the WHO identified children with lower QOL scores to start ART; however, children who did not fit ART-initiation criteria and those who were younger also displayed poor QOL. QOL assessment should be considered in untreated children to inform decisions about when to initiate ART.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Article-1 ObjectType-Feature-2
ISSN:	0954-0121 1360-0451
DOI:	10.1080/09540121.2011.592815