Low Quality of Life,Falls, and Pre-Frailty are Associated with Depressive Symptoms in Virologically Suppressed PLWHIV in Salvador,Brazil

AIDS and Behavior - Depression is the leading cause of years lived with disability worldwide and PLWHIV present a higher risk of developing depressive symptoms. We aimed to evaluate depressive...     

Oral health and quality of life of people living with human T-cell leukemia virus-1 in Salvador,Brazil: a cross-sectional study

Clinical Oral Investigations - To compare the oral health status and oral health-related quality of life (OHRQoL) in symptomatic and asymptomatic patients with human T-cell leukemia virus-1...     

Changes health-related quality of life in HIV-infected patients following initiation of antiretroviral therapy: a longitudinal study

BackgroundSeveral tools have been developed to evaluate HIV health-related quality of life (HRQoL) during and after antiretroviral therapy (ART). Few longitudinal studies evaluated the effect of ART on the quality of life of HIV patients.ObjectiveTo evaluate changes in HRQoL in HIV-infected individuals one year after initiating ART.MethodsA prospective study was conducted from May 2016 to July 2018. Data on clinical and sociodemographic characteristics of 91 HIV-infected patients were collected prior to initiation of ART and one year thereafter. Demographic and clinical data were collected and the questionnaires 36-item Short Form Health Survey (SF-36) and HIV/AIDS-targeted quality of life (HAT-QoL) were administered in both periods. Asymptomatic individuals, aged ≥18 years, were included in the study. Patients who discontinued treatment were excluded. The association between predictors of physical and mental HRQoL was analyzed by multiple linear regression analysis.ResultsPatients were predominantly male (78.0%), mean age 35.3 ± 10.7 years, with no stable relationship (80.2%), and no comorbidities (73.6%). Most of the SF-36 domains improved after one year, particularly Physical Function (p = 0.0001), General Health (p = 0.0001), Social Functioning (p = 0.0001), Mental Health (p = 0.001), and Mental Component Summary (p = 0.004). HAT-QoL domains improved in the Overall Function (p = 0.0001), Life Satisfaction (p = 0.0001), Provider Trust (p = 0.001), and Sexual Function (p = 0.0001) domains. Sex (p = 0.032), age (p = 0.001), income (p = 0.007), and stable relationship (p = 0.004) were good predictors of the Physical Component Summary. Sex (p = 0.002) and stable relationship (p = 0.038) were good predictors of the Mental Component Summary. SF-36 and HAT-QoL scales presented strong correlations, except for Medication Concerns (0.15–0.37), HIV Mastery (0.18–0.38), Disclosure Worries (?0.15 to 0.07), and Provider Trust (?0.07 to 0.15).ConclusionsART improved HRQoL after one year of use. The HAT-QoL and SF-36 correlated well and are good tools to evaluate HRQoL in HIV-infected patients on ART.     

Unusual oral findings of the toxic epidermal necrolysis in an HIV-infected patient: a case report

Erythema multiforme (EM), Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (TEN) have been reported as possible adverse effects of some classes of first-line antiretroviral drugs (ART) for HIV treatment. Herein we report an unusual presentation of TEN lesions associated with ART in an HIV-infected patient. The patient presented disseminated cutaneous eruption and oral lesions from the lips to the oropharynx region, causing odynophagia and dysphagia. In the tongue, circular, atypical erythematous lesions appeared, increasing in diameter over seven days and coalescing since then to complete remission. TEN treatment included efavirenz interruption, use of methylprednisolone, prophylactic antibiotic, and daily laser therapy with low-intensity red light. The circular oral lesions have not been described yet. Reporting our findings and clinical management may help diagnosing other similar cases and guide the clinical conduct. Analgesia and acceleration of oral ulcer repair with red laser therapy are recommended.     

Validity and reliability of the 36-Item Short Form Health Survey questionnaire version 2 among people living with HIV in Brazil

BackgroundThe 36-Item Short Form Health Survey questionnaire (SF-36) is a widely used instrument for evaluating health-related quality-of-life (HRQoL). The psychometric validation of the SF-36 version 2.0 (SF-36v2) in HIV-infected patients had not yet conducted in Brazil.AimTo test data quality, reliability and validity of the SF-36v2 as a measure of HRQoL among Brazilian individuals living with HIV.MethodsA cross-sectional study included 393 HIV-infected patients in whom HRQoL was assessed by using the SF-36v2 questionnaire. Demographic characteristics, socioeconomic status and clinical data were also collected. The SF-36 version 1 translated into Brazilian-Portuguese was adapted and introduced version 2 improvements according to the instrument developers. SPSS version 21 was used for data analyses. Confirmatory factor analysis (CFA) and structural equation modelling were performed using AMOS SPSS version 18. T-test for independent samples was used to compare differences between mean levels of HRQoL components in different groups. Linear multiple regression techniques were used to analyze the relationship between Physical Component Summary (PCS), Mental Component Summary (MCS) and independent variables.ResultsWe performed the CFA and tested the hypothetical measurement model. We included five parameters to improve the adherence of data to the model. All indicators met the requirement suggested by specialized literature (χ2 (gl): 980.7 (527); CFI: 0.949; GFI: 0.873; TLI: 0.943; RMSEA: 0.047; 90% IC: 0.042-0.051). Multiple regression analyses revealed that depression (p = 0.001), family income (p = 0.007), sex (p = 0.001) and age (p< 0.021) were associated with MCS. Comorbidities (p = 0.001), health self-perception (p = 0.001), age (p = 0.001), and sex (p = 0.025) were associated with PCS.ConclusionsA consistent validation of the SF-36v2 in Brazilian HIV patients were shown. Further studies with SF-36v2 psychometric analyses would be required in other populations to establish Brazilian normative data.