Quality of life among HIV-infected individuals failing first-line antiretroviral therapy in resource-limited settings

AIDS Care. 2018 Aug;30(8):954-962. doi: 10.1080/09540121.2018.1427207. Epub 2018 Jan 18.


We evaluated health-related quality of life (QoL) in HIV infection participants with virologic failure (VF) on first-line antiretroviral therapy (ART) in 9 resource-limited settings (RLS). ACTG SF-21 was completed by 512 participants at A5273 study entry; 8 domains assessed: general health perceptions (GHP), physical functioning (PF), role functioning (RF), social functioning (SF), cognitive functioning (CF), pain (P), mental health (MH), and energy/fatigue (E/F); each was scored between 0 (worst) to 100 (best). Mean QoL scores ranged from 67 (GHP) to 91 (PF, SF, CF). QoL varied by country; high VL and low CD4 were associated with worse QoL in most domains, except RF (VL only), SF (CD4 only) and CF (neither). Number of comorbidities, BMI and history of AIDS were associated with some domains. Relationships between QoL and VL varied among countries for all domains. The association of worse disease status with worse QoL may reflect low QoL when ART was initiated and/or deterioration associated with VF.

Keywords: HIV; Health-related quality of life; antiretroviral therapy; resource-limited settings; virologic failure.

Publication types

  • Clinical Trial, Phase III
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Anti-HIV Agents / therapeutic use*
  • Female
  • HIV Infections / drug therapy*
  • HIV Infections / psychology*
  • HIV Infections / virology
  • Humans
  • Male
  • Middle Aged
  • Quality of Life / psychology*
  • Treatment Outcome
  • Viral Load


  • Anti-HIV Agents