Med Decis Making - Health-Related Quality of Life in HIV-Infected and At-Risk Women: The Impact of Illicit Drug Use and Hepatitis C on a Community Preference Weighted Measure.


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RPOSE: To assess the impact of illicit drug use and chronic hepatitis C virus (HCV) on health-related quality of life (HRQoL) in women with HIV or at risk for HIV infection.METHODS: Cross-sectional analysis of data from the Women's Interagency Health Study (WIHS) of women with HIV (n = 2508) and at high risk of HIV infection (n = 889) in the US. A Short-Form-6D (SF-6D) HRQoL measure derived from the Medical Outcomes Study-HIV (MOS-HIV) questionnaire, HIV infection status, CD4 cell count (a measure of immune status), antiretroviral treatment, current illicit drug use (heroin and/or cocaine), and HCV status were assessed at a recent study visit. We developed multivariate linear regression models adjusting for age, race/ethnicity, education, and testing for interactions.RESULTS: HIV-infected women with =200 CD4 cells/?L had lower mean HRQoL scores (0.69) than either HIV-infected women with >200 CD4 cells/?L (0.78) or HIV-uninfected women (0.80) (P < 0.01). In multivariate analysis, illicit drug use, chronic HCV, and low CD4 count were independently associated with lower HRQoL. There was a differential effect of HCV and illicit drug use for HIV-infected women depending on CD4 cell count: HIV-infected women with >200 CD4 cells/?L had a significantly greater reduction in HRQoL associated with illicit drug use (-0.063) and chronic HCV (-0.036) than women with =200 CD4 cells/?L (-0.017, -0.005 respectively).CONCLUSIONS: Poorly controlled HIV, illicit drug use, and chronic HCV are associated with lower HRQoL. Illicit drug use and chronic HCV have greater HRQoL impacts for HIV-infected women with well-controlled HIV versus those with poorly controlled HIV, which may affect clinical and policy priorities.

Resumo Limpo

rpose assess impact illicit drug use chronic hepat c virus hcv healthrel qualiti life hrqol women hiv risk hiv infectionmethod crosssect analysi data women interag health studi wih women hiv n high risk hiv infect n us shortformd sfd hrqol measur deriv medic outcom studyhiv moshiv questionnair hiv infect status cd cell count measur immun status antiretrovir treatment current illicit drug use heroin andor cocain hcv status assess recent studi visit develop multivari linear regress model adjust age raceethn educ test interactionsresult hivinfect women cd cellsl lower mean hrqol score either hivinfect women cd cellsl hivuninfect women p multivari analysi illicit drug use chronic hcv low cd count independ associ lower hrqol differenti effect hcv illicit drug use hivinfect women depend cd cell count hivinfect women cd cellsl signific greater reduct hrqol associ illicit drug use chronic hcv women cd cellsl respectivelyconclus poor control hiv illicit drug use chronic hcv associ lower hrqol illicit drug use chronic hcv greater hrqol impact hivinfect women wellcontrol hiv versus poor control hiv may affect clinic polici prioriti

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