Tristan Alain, Fabienne Marcellin, Pascal Bessonneau, Laurent Hocqueloux, Holger Muehlan, Clotilde Allavena, David Zucman, Ester Villalong-Olives, Olivier Chassany, Martin Duracinsky
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引用次数: 0
Abstract
Introduction: Socioeconomic, behavioral, and psychosocial factors-beyond just biological and hormonal factors-drive sex differences in HIV outcomes. The PROBI study evaluated treatment acceptability, perceived toxicity, and health-related quality of life (HRQL) among people living with HIV (PLWH) switching from multiple antiretroviral therapy to oral dual therapy. Higher treatment discontinuation rates were observed among women, prompting this analysis of sex-based HRQL differences.
Methods: HRQL, treatment acceptability, and symptom burden data were collected at treatment switch (D0) and at 1 and 6 months afterward (M1 and M6). Higher scores indicated greater symptom burden (HIV-SI), better HRQL (PROQOL-HIV), or better treatment acceptability. Sex differences were analyzed using appropriate statistical tests, with overtime changes assessed via mixed-effects linear regression models.
Results: The study included 260 PLWH (35% women, n = 92), with a mean age of 51 ± 12 years. Compared to men, women were more frequently born in sub-Saharan Africa (46% vs. 12%), had lower educational attainment (20% vs. 41% with university degrees), and higher rates of obesity (29% vs. 9% with BMI ≥ 30). While no virologic failures occurred, treatment discontinuation was higher among women (15% vs. 5%). Over time, all participants showed improvements in symptom burden (-2 points), treatment-related HRQL (+5 points), mental/cognitive HRQL (+4 points), and treatment acceptability (+6 points). However, women consistently demonstrated worse cognitive and mental HRQL scores compared to men (mean difference: -7 points).
Conclusion: While dual therapy improved treatment acceptability and HRQL for both sexes, women maintained lower mental and cognitive HRQL scores. Enhanced patient-provider communication may help identify HRQL changes, especially among women who face higher treatment discontinuation risk.
期刊介绍:
AIDS Research and Treatment is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies focused on all aspects of HIV and AIDS, from the molecular basis of disease to translational and clinical research. In addition, articles relating to prevention, education, and behavior change will be considered