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What determines health-related quality of life among people living with HIV : an updated review of the literature

Sophie Degroote (UGent) , Dirk Vogelaers (UGent) and Dominique Vandijck (UGent)
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Abstract
Background: As infection with the Human Immunodeficiency Virus (HIV) has evolved to a chronic disease, perceived health-related quality of life (HRQoL) is becoming a prominent and important patient-reported outcome measure in HIV care. Literature discusses different factors influencing HRQoL in this population, however, currently no consensus exists about the main determinants. In this review a clear, up-to-date overview of the determinants influencing HRQOL among people living with HIV is provided. Methods: All studies published before July 2013 that identified determinants of HRQoL among people living with HIV in high-income countries, were considered in this narrative review. PubMed, Web of Science and The Cochrane Library were consulted using the keywords ‘determinants’, ‘quality of life’, ‘HIV’ and ‘AIDS’. To be included, studies should have reported overall health and/or physical/mental health scores on a validated instrument and performed multivariable regression analyses to identify determinants that independently influence perceived HRQoL. Results: In total, 49 studies were included for further analysis and they used a variety of HRQoL instruments: Medical Outcomes Study Short Form-36 or variants, Medical Outcomes Study-HIV, HIV Cost and Services Utilization Study measure, Multidimensional Quality of Life Questionnaire, HIV targeted quality of life instrument, Functional Assessment of Human Immunodeficiency Virus Infection, HIV Overview of Problems Evaluation System, EuroQol, Fanning Quality of Life scale, Health Index and PROQOL-HIV. In this review, the discussed determinants were thematically divided into socio-demographic, clinical, psychological and behavioural factors. Employment, immunological status, presence of symptoms, depression, social support and adherence to antiretroviral therapy were most frequently and consistently reported to be associated with HRQoL among people living with HIV. Conclusions: HRQoL among people living with HIV is influenced by several determinants. These determinants independently, but simultaneously impact perceived HRQoL. Most HRQoL instruments do not capture all key determinants. We recommend that the choice for an instrument should depend on the purpose of the HRQoL assessment.
Keywords
Acquired immunodeficiency syndrome, Epidemiologic factors, Review, HIV, Quality of life

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MLA
Degroote, Sophie, Dirk Vogelaers, and Dominique Vandijck. “What Determines Health-related Quality of Life Among People Living with HIV : an Updated Review of the Literature.” ARCHIVES OF PUBLIC HEALTH 72 (2014): n. pag. Print.
APA
Degroote, S., Vogelaers, D., & Vandijck, D. (2014). What determines health-related quality of life among people living with HIV : an updated review of the literature. ARCHIVES OF PUBLIC HEALTH, 72.
Chicago author-date
Degroote, Sophie, Dirk Vogelaers, and Dominique Vandijck. 2014. “What Determines Health-related Quality of Life Among People Living with HIV : an Updated Review of the Literature.” Archives of Public Health 72.
Chicago author-date (all authors)
Degroote, Sophie, Dirk Vogelaers, and Dominique Vandijck. 2014. “What Determines Health-related Quality of Life Among People Living with HIV : an Updated Review of the Literature.” Archives of Public Health 72.
Vancouver
1.
Degroote S, Vogelaers D, Vandijck D. What determines health-related quality of life among people living with HIV : an updated review of the literature. ARCHIVES OF PUBLIC HEALTH. 2014;72.
IEEE
[1]
S. Degroote, D. Vogelaers, and D. Vandijck, “What determines health-related quality of life among people living with HIV : an updated review of the literature,” ARCHIVES OF PUBLIC HEALTH, vol. 72, 2014.
@article{5782889,
  abstract     = {Background: As infection with the Human Immunodeficiency Virus (HIV) has evolved to a chronic disease, perceived health-related quality of life (HRQoL) is becoming a prominent and important patient-reported outcome measure in HIV care. Literature discusses different factors influencing HRQoL in this population, however, currently no consensus exists about the main determinants. In this review a clear, up-to-date overview of the determinants influencing HRQOL among people living with HIV is provided. 
Methods: All studies published before July 2013 that identified determinants of HRQoL among people living with HIV in high-income countries, were considered in this narrative review. PubMed, Web of Science and The Cochrane Library were consulted using the keywords ‘determinants’, ‘quality of life’, ‘HIV’ and ‘AIDS’. To be included, studies should have reported overall health and/or physical/mental health scores on a validated instrument and performed multivariable regression analyses to identify determinants that independently influence perceived HRQoL. 
Results: In total, 49 studies were included for further analysis and they used a variety of HRQoL instruments: Medical Outcomes Study Short Form-36 or variants, Medical Outcomes Study-HIV, HIV Cost and Services Utilization Study measure, Multidimensional Quality of Life Questionnaire, HIV targeted quality of life instrument, Functional Assessment of Human Immunodeficiency Virus Infection, HIV Overview of Problems Evaluation System, EuroQol, Fanning Quality of Life scale, Health Index and PROQOL-HIV. In this review, the discussed determinants were thematically divided into socio-demographic, clinical, psychological and behavioural factors. Employment, immunological status, presence of symptoms, depression, social support and adherence to antiretroviral therapy were most frequently and consistently reported to be associated with HRQoL among people living with HIV. 
Conclusions: HRQoL among people living with HIV is influenced by several determinants. These determinants independently, but simultaneously impact perceived HRQoL. Most HRQoL instruments do not capture all key determinants. We recommend that the choice for an instrument should depend on the purpose of the HRQoL assessment.},
  articleno    = {40},
  author       = {Degroote, Sophie and Vogelaers, Dirk and Vandijck, Dominique},
  issn         = {0778-7367},
  journal      = {ARCHIVES OF PUBLIC HEALTH},
  keywords     = {Acquired immunodeficiency syndrome,Epidemiologic factors,Review,HIV,Quality of life},
  language     = {eng},
  pages        = {10},
  title        = {What determines health-related quality of life among people living with HIV : an updated review of the literature},
  url          = {http://dx.doi.org/10.1186/2049-3258-72-40},
  volume       = {72},
  year         = {2014},
}

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