Specific Factors Have Greater Impact on Quality of Life in HIV Patients with Lipodystrophy

Now that HIV type 1 (HIV-1) infection is considered to be a chronic illness, quality of life (QoL) has become an important outcome measurement. Few instruments specifically measure QoL in HIV-1infected patients, and none are specific for lipodystrophy (LD) in such patients.

HAART can produce side effects that may impair QoL and threaten compliance; in spite of this, <3% of drug trial publications incorporate measurement of QoL as an outcome variable.

Instruments that assess body image should be developed to measure QoL in HIV-1infected patients, and more attention should be paid to specific dimensions of QoL in the management of HIV-1infected patients.

In this study, a standardized questionnaire was used to assess the impact of lipodystrophy (LD) on quality of life (QoL).

Eighty-four consecutive asymptomatic HIV patients with clinical LD completed a modified version of the Dermatology Life Quality Index (DLQI) survey to measure the impact of body fat changes on their QoL.

Body changes influenced dressing for 55 patients (65%), produced feelings of shame for 41 (49%), and disrupted sexual life for 23 (27%).

There was a greater impact on the DLQI due to body changes among women, injection drug users, patients with abdominal or breast lipoaccumulation, and patients with a high number of non-LD side effects.

Multivariate proportional odds model analysis showed that the severity of nonLD-associated side effects and the presence of breast lipoaccumulation were associated with impaired psychosocial functioning.

The authors conclude, “Specific characteristics of patients, antiretroviral-based side effects, and breast lipoaccumulation exert a greater impact on QoL in HIV-1infected patients with LD.”

06/07/04

Reference
J Blanch and others. Factors Associated with Severe Impact of Lipodystrophy on the Quality of Life of Patients Infected with HIV-1. Clinical Infectious Diseases 38(10): 1464-1470. May 15, 2004.