4051.0: Tuesday, October 23, 2001 - Board 7

Abstract #29974

Antiretroviral therapy and quality of life in children with perinatally acquired HIV infection

Mary G. Boland, DrPH1, Deborah S. Storm, PhD1, Steve Gortmaker, PhD2, and James M. Oleske, MD MPH3. (1) François-Xavier Bagnoud Center, University of Medicine and Dentistry of New Jersey, ADMC #4, 30 Bergen St., Newark, NJ 07103, 973-972-0408, bolandmg@umdnj.edu, (2) Health and Social Behavior, Harvard Prevention Research Center, 677 Huntington Avenue, 7th Floor, Boston, MA 02115, (3) Department of Pediatrics, University of Medicine and Dentistry of New Jersey, F-570A Medical Science Building, 185 S. Orange Ave., Newark, NJ 07103

Perinatally acquired HIV infection is a chronic, debilitating, and fatal condition. The recent introduction of antiretroviral therapy regimens has decreased mortality and morbidity in children with HIV/AIDS. The relationship of such therapy to disease progression and health-related quality of life (QOL) is unknown. Purpose: This study examined the relationship between highly active antiretroviral therapy (HAART) and quality of life in HIV infected children. Method: QOL was assessed annually in HIV infected children aged 5 to 21 yrs (n=867) enrolled in the Pediatric Late Outcomes Study (Protocol 219) of the PACTG. The study sample was 51% African-American, 33% Hispanic, and 15% white with a mean age of 9.7 yrs (5-21); 76% had HIV vs. 43% with AIDS. 57% had not been told their diagnosis. Antiretroviral therapy was categorized as HAART (>1 PI’s) and non-HAART(no PI). Caretakers complete a standardized survey of five QOL domains: health perceptions; physical, psychological and social/role functioning; and HIV symptoms. Results: In this cross-sectional analysis, children on HAART had significantly lower CD4% (t=-2.43, df=865, P=.015) and were more likely to have an AIDS diagnosis than those on non-HAART ( ÷2=(1) 21.009, P=.000). Stepwise regression of demographic, social and disease factors on QOL indicated that HAART predicted lower social/school functioning (B=.0819, P=.000) but was not a significant predictor for the remaining four QOL domains. Severity of illness had a significant effect on QOL. Health care utilization was the strongest predictor in four of five QOL domains. Additional work is needed to understand what other factors influence QOL in children with HIV infection.

Learning Objectives: At the conclusion of this session the participant will be able to : 1. Define the components of health-related quality of life (QOL) for children with HIV infection 2. Discuss two issues affecting the measurement of QOL in children 3. Describe the influence of highly active antiretroviral therapy (HAART) on the QOL of children 5-21 yrs with HIV infection

Keywords: HIV/AIDS, Quality of Life

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA