艾滋病患者高效抗逆转录病毒治疗依从性及生活质量分析

Adherence to highly active antiretroviral therapy and quality of life in patients with acquired immunedeficiency syndrome

目的探讨艾滋病患者高效抗逆转录病毒治疗依从性、生活质量特点及相关因素。方法在湖南、湖北、安徽3省采用整群抽样方法,对308名接受免费高效抗逆转录病毒治疗的患者进行现场调查。采用美国社区艾滋病临床研究抗逆转录病毒用药自陈式问卷(CPCRA)和SF-36生活质量问卷,通过面对面访谈收集资料。结果本组患者的抗病毒治疗服药平均依从程度为94.0%,有20.5%的患者属于服药依从性差。SF-36生活质量各领域得分均显著低于常模(P<0.05),服药依从程度好的患者在生理功能、躯体疼痛、一般健康状况、社会功能、情感职能领域得分优于依从程度差的患者(P<0.05)。吸毒、治疗时间、药物不良反应、机会性感染影响生活质量。结论接受抗病毒治疗的艾滋病患者生活质量偏低。为达到治疗目标,需通过综合干预提高患者服药依从性,同时应管理患者吸毒行为、机会性感染及药物不良反应,以改善患者生活质量。

Objective To explore the level of adherence to highly active antiretroviral therapy （HAART） and quality of life in HIV/AIDS patients and related factors. Methods In Hunan,Hubei,and Anhui provinces,308 HIV/AIDS patients who receiving free highly active antiretroviral therapy were investigated with cluster sampling. A questionnaire of Community Praga＇ams for Clinical Research on AIDS （CPCRA） Antiretroviral Medication Self-Report was used to assess adherence to HAART and SF-36 was administered to assess quality of life in HIV/AIDS patients. Face-to-face interview was conducted to collect data. Results The average level of adherence to HAART was 94% among 308 patients. There were 20.5% of the patients falling to the category of poor adherence to HAART. The scores of SF-36 domains in HIV/AIDS were significantly lower than norms （P〈0.05）. Patients with good adherence to HAART had better scores in the domains of physical function,bodily pain,general health,social function and role-emotional than patients with poor adherence （P〈0.05）. Drug use,treatment time,adverse reaction,and opportunity infection had impacts on quality of life. Conclusion HIV/AIDS patients receiving HAART had low level of quality of life. In order to achieve treatment goal,comprehensive intervention is required to improve adherence to HAART, and manage drug use behavior,opportunity infections and side effects to improve quality of life in HIV/AIDS patients.