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https://www.arca.fiocruz.br/handle/icict/28806
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PreprintDireito Autoral
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- INI - Preprint [77]
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QUALITY OF LIFE IMPROVEMENT IN RESOURCE-LIMITED SETTINGS AFTER ONE YEAR OF SECOND-LINE ANTIRETROVIRAL THERAPY USE AMONG ADULT MEN AND WOMEN
Raltegravir
HIV
Second-line therapy
Antiretroviral Therapy
Resource-limited settings
Randomized clinical trial
https://www.arca.fiocruz.br/handle/icict/57161
Autor(es)
Afiliação
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Asociación Civil Impacta Salud y Educación, Lima, Peru.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA / UNC Project Lilongwe, Malawi.
AMPATH at Moi University Teaching Hospital, Eldoret, Kenya.
Durban Adult HIV CRS, South Africa.
Wits Health Consortium Department of Medicine, University of Witwatersrand, Johannesburg, South Africa.
Department of Medicine, University of Washington, Seattle, WA, USA.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Asociación Civil Impacta Salud y Educación, Lima, Peru.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brasil.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA / UNC Project Lilongwe, Malawi.
AMPATH at Moi University Teaching Hospital, Eldoret, Kenya.
Durban Adult HIV CRS, South Africa.
Wits Health Consortium Department of Medicine, University of Witwatersrand, Johannesburg, South Africa.
Department of Medicine, University of Washington, Seattle, WA, USA.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Resumo em Inglês
OBJECTIVE: We evaluated improvement of quality of life (QoL) after one year of secondline
antiretroviral therapy (ART) use in resource-limited settings (RLS) among adult men and
women, comparing two randomized treatment arms.
DESIGN: ACTG A5273 was a randomized clinical trial of second-line ART comparing
lopinavir/ritonavir (LPV/r) + raltegravir (RAL) with LPV/r + nucleos(t)ide reverse
transcriptase inhibitors (NRTIs) in participants failing a non-nucleoside reverse transcriptase
inhibitor (NNRTI)-containing regimen at 15 sites in 9 RLS. Participants completed the
ACTG SF-21 which has 8 QoL domains with a standard score ranging from 0 (worst) to 100
(best).
METHODS: Differences in QoL by randomized arm, as well as by demographic and clinical
variables, were evaluated by regression models for baseline and week 48 QoL scores fitted
using the generalized estimating equations method (GEE).
RESULTS: 512 individuals (49% male, median age 39 years) were included. 512 and 492
participants had QoL assessments at baseline and week 48, respectively. QoL improved
significantly from week 0 to 48 (p<0.001 for all domains). There was no significant
difference between treatment arms for any domain. Individuals with higher VL and lower
CD4 at baseline had lower mean QoL at baseline but larger improvements such that mean
QoL was similar at week 48.
CONCLUSIONS: Improvements in QoL were similar after starting second-line ART of
LPV/r combined with either RAL or NRTIs in RLS. QoL scores at baseline were lower
among participants with worse disease status prior to starting second-line, but after one year
similar QoL scores were achieved.
Palavras-chave em inglês
Quality of lifeRaltegravir
HIV
Second-line therapy
Antiretroviral Therapy
Resource-limited settings
Randomized clinical trial
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