Quality of life in patients treated with first-line antiretroviral therapy containing nevirapine and/or efavirenz

van Leth, Frank, Conway, Brian, Laplumé, Hector, Martin, Des, Fisher, Martin, Jelaska, Ante, Wit, Ferdinand W and Lange, Joep M A (2004) Quality of life in patients treated with first-line antiretroviral therapy containing nevirapine and/or efavirenz. Antiviral Therapy, 9 (5). pp. 721-728. ISSN 1359-6535

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Objective: To assess whether differences in safety profiles between nevirapine (NVP) and efavirenz (EFV), as observed in the 2NN study, translated into differences in ‘health related quality of life’ (HRQoL).

Design: A sub-study of the 2NN study, with antiretroviral-naive patients randomly allocated to NVP (once or twice daily), EFV or NVP+EFV, in addition to stavudine and lamivudine. Methods: Comparing differences in changes of HRQoL over 48 weeks as measured with the Medical Outcomes Study HIV Health Survey (MOS-HIV) questionnaire, using Analysis of Variance.

Results: The 2NN study enrolled 1216 patients. No validated questionnaires were available for 244 patients, and 55 patients had no HRQoL data at all, leaving 917 patients eligible for this sub-study. A total of 471 (51%) had HRQoL measurements both at baseline and week 48. The majority (69%) of patients without HRQoL measurements did, however, complete the study. The change in the ‘physical health summary score’ (PHS) was 3.9 for NVP, 3.4 for EFV and 2.4 for NVP+EFV (P=0.712). For the ‘mental health summary score’ (MHS) these values were 6.1, 7.0 and 3.9, respectively (P=0.098). A baseline plasma HIV-1 RNA concentration (pVL) ≥100 000 copies/ml and a decline in pVL (per log10) were independently associated with an increase of PHS. An increase of MHS was only associated with pVL-decline. Patients experiencing an adverse event during follow-up had a comparable change in PHS but a significantly smaller change in MHS, compared with those without an adverse event.

Conclusions: First-line ART containing NVP and/or EFV leads to an improvement in HRQoL. The gain in HRQoL was similar for NVP and EFV, but slightly lower for the combination of these drugs.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Depositing User: EPrints Services
Date Deposited: 21 Feb 2012 10:04
Last Modified: 10 Jan 2020 14:34
URI: http://sro.sussex.ac.uk/id/eprint/38048
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