Associations of Symptoms and Health-Related Quality of Life: Findings from a National Study of Persons with HIV Infection

1 May 2001 | Volume 134 Issue 9 Part 2 | Pages 854-860

Background: Health-related quality of life refers to how well people are able to perform daily activities (functioning) and how they feel about their lives (well-being). The relationship between symptoms and health-related quality of life has not been fully explored.

Objective: To estimate the association of HIV symptoms with health-related quality of life and with disability days.

Design: Prospective cohort study.

Setting: HIV providers in 28 urban and 24 rural randomly selected sites throughout the United States.

Patients: Nationally representative sample of 2267 adults with known HIV infection who were interviewed in 1996 and again between 1997 and 1998.

Measurements: Symptoms, two single-item global measures of health-related quality of life (perceived health and perceived quality of life), and disability days.

Results: White patches in the mouth; nausea or loss of appetite; persistent cough, difficulty breathing, or difficulty catching one's breath; and weight loss were associated with more disability days and worse scores on both health-related quality-of-life measures. Headache; pain in the mouth, lips, or gums; dry mouth; and sinus infection, pain, or discharge were associated with worse perceived health. Pain in the mouth, lips, or gums; trouble with eyes; pain, numbness, or tingling of hands or feet; and diarrhea or loose or watery stools were associated with worse perceived quality of life. Headache and fever, sweats, or chills were associated with more disability days.

Conclusions: Several symptoms are associated with worse health-related quality of life and more disability days in persons with HIV infection. In such patients, targeting specific symptoms may improve health-related quality of life and reduce disability.

Author and Article Information

From the Veterans Affairs Greater Los Angeles Healthcare System and University of California, Los Angeles, Los Angeles; and Veterans Affairs San Diego Healthcare System and University of California, San Diego, San Diego, California.
Note: This article is one of a series of articles comprising an Annals of Internal Medicine supplement entitled " Investigating Symptoms: Frontiers in Primary Care Research—Perspectives from The Seventh Regenstrief Conference " To see a complete list of the articles included in this supplement, please view its Table of Contents.

Grant Support: The HIV Cost and Services Utilization Study is being conducted under cooperative agreement HS08578 between RAND and the Agency for Healthcare Research and Quality (Dr. Shapiro, Principal Investigator; Dr. Bozzette, Co–Principal Investigator). Substantial additional support for this agreement was provided by the Health Resources and Services Administration, the National Institute for Mental Health, the National Institute for Drug Abuse, and the National Institutes of Health Office of Research on Minority Health through the National Institute for Dental Research. The Robert Wood Johnson Foundation, Merck and Co., Glaxo Wellcome, and the National Institute on Aging provided additional support. Drs. Asch and Bozzette are supported by Health Services Research and Development Career Development Awards from the Department of Veterans Affairs. This study was also supported by grant R01AS10227 from the Agency for Healthcare Research and Quality.

Requests for Single Reprints: Karl A. Lorenz, MD, Division of General Internal Medicine, Veterans Affairs Greater Los Angeles Healthcare System, 11303 Wilshire Boulevard, Code 111-G, Los Angeles, CA 90073; e-mail: klorenz@ucla.edu.

Current Author Addresses: Drs. Lorenz and Asch: Division of General Internal Medicine, Veterans Affairs Greater Los Angeles Healthcare System, 11303 Wilshire Boulevard, Code 111-G, Los Angeles, CA 90073.

Dr. Shapiro: Division of General Internal Medicine and Health Services Research, University of California, Los Angeles, 911 Broxton Plaza, Room 208, Box 951736, Los Angeles, CA 90095-1736.

Dr. Bozzette: Health Services Research and Development, University of California, San Diego, Department of Medicine (Code 111-N), Veterans Affairs San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92163.

Dr. Hays: University of California, Los Angeles, AIDS Institute, 911 Broxton Plaza, Room 110, Box 951736, Los Angeles, CA 90095-1736.