Abstract
We tested whether health related quality of life (HRQOL) predicts mortality, development
of active cytomegalovirus (CMV) disease, and study retention. We studied 957 patients
with CD4 counts <100 cells/mm3 in AIDS Clinical Trials Group Protocol 204, a randomized, double-blind trial comparing
three prophylactic regimens against CMV end-organ disease. The MOS-HIV, a brief HRQOL
questionnaire, generated physical health summary (PHS) and mental health summary (MHS)
scores. We used Cox proportional hazards to predict events by baseline HRQOL, adjusted
for treatment, demographics, and CD4. Each point increase in baseline PHS decreased
the risk of death by 4%, CMV by 2%, and dropout by 2%. Each point increase in baseline
MHS decreased the risk of death by 4% and study dropout by 1%. In conclusion, self-rated
physical and mental health demonstrated predictive validity for survival, CMV end-organ
disease, and retention in advanced HIV patients. The results show the clinical importance
of HRQOL and may facilitate interpretation by clinicians.
Keywords
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References
- Applications of the medical outcomes study health-related quality of life measures in HIV/AIDS.Qual Life Res. 1997; 6: 531-554
- Recombinant human growth hormone in patients with HIV-associated wasting: a randomized, placebo-controlled trial. Serostim Study Group.Ann Intern Med. 1996; 125: 873-882
- Health-related quality of life assessed before and during chemotherapy predicts survival in multiple myeloma.Br J Haematol. 1997; 97: 29-37
- Relation between tumor size, quality of life, and survival in patients with colorectal liver metastases.J Clin Oncol. 1996; 14: 171-175
- Baseline quality of life as a predictor of mortality and hospitalization in 5,025 patients with congestive heart failure.Am J Cardiol. 1996; 78: 890-895
- A health status questionnaire using 30 items from the Medical Outcomes Study: preliminary validation in persons with early HIV infection.Med Care. 1991; 29: 786-798
- Reliability and validity of physical and mental health summary scores from the Medical Outcomes Study HIV Health Survey.Med Care. 1998; 36: 126-137
- Functional status of persons with HIV infection in an ambulatory setting.J Acquir Immune Defic Syndr. 1994; 7: 1050-1056
- The effect of valaciclovir on cytomegalovirus viremia and viruria detected by polymerase chain reaction in patients with advanced human immunodeficiency virus disease. AIDS Clinical Trials Group Protocol 204/Glaxo Wellcome 123–014 International CMV Prophylaxis Study Group.J Infect Dis. 1998; 177: 57-64
- A randomized, double-blind trial of valaciclovir prophylaxis for cytomegalovirus disease in patients with advanced human immunodeficiency virus infection.J Infect Dis. 1998; 177: 48-56
- The role of functional status in predicting inpatient mortality with AIDS: a comparison with current predictors.J Clin Epidemiol. 1997; 49: 193-201
- Risk Factors for 5-year mortality in older adults: the Cardiovascular Health Study.JAMA. 1998; 279: 585-592
- Continued survival of older hemodialysis patients: investigation of psychosocial predictors.Am J Kidney Dis. 1994; 24: 42-49
- Utility of urine and leukocyte cultures and plasma DNA polymerase chain reaction for identification of AIDS patients at risk for developing human cytomegalovirus disease.J Infect Dis. 1997; 175: 302-308
- Cytomegalovirus (CMV) viraemia detected by polymerase chain reaction identifies a group of HIV-positive patients at high risk of CMV disease.AIDS. 1997; 11: 889-893
- Cytomegalovirus (CMV) DNA load is an independent predictor of CMV disease and survival in advanced AIDS.J Virol. 1999; 73: 7027-7030
- Can dropout and other noncomplicance be minimized in a clinical trial? Report from the Veterans Administrative National Heart, Lung and Blood Institute Cooperative Study on Antihypertensive Therapy. Mild hypertension.Control Clin Trials. 1982; 3: 75-89
- Can categorization of patient background problems be used to determine early termination in a clinical trial?.Control Clin Trials. 1988; 9: 47-63
- Retention of asthmatic patients in a longitudinal clinical trial.J Allergy Clin Immunol. 1997; 99: 197-203
- Macular Photocoagulation Study Group. Patient and clinic factors predictive of missed visits and inactive status in a multicenter clinical trial.Control Clin Trials. 1992; 13: 40-49
- Self-ratings of health: do they also predict change in functional ability?.J Gerontol Soc Sci. 1995; 50B: S344-S353
- Depression is a risk factor for coronary artery disease in men: the precursors study.Arch Intern Med. 1998; 158: 1422-1426
- Declining morbidity and mortality among patients with advanced human immunodeficiency virus syndrome.N Engl J Med. 1998; 338: 853-860
- Update: Trends in AIDS incidence–United States, 1996.MMWR. 1997; 46: 861-867
- Evidence for reliability, validity and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV).Qual Life Res. 1997; 6: 481-493
Article info
Publication history
Accepted:
February 28,
2001
for the Outcomes Committee of the Adult AIDS Clinical Trials GroupIdentification
Copyright
© 2003 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
