The impact of antiretroviral therapy on symptom burden among HIV outpatients with low CD4 count in rural Uganda: nested longitudinal cohort study.
Identifieur interne : 000B64 ( PubMed/Corpus ); précédent : 000B63; suivant : 000B65The impact of antiretroviral therapy on symptom burden among HIV outpatients with low CD4 count in rural Uganda: nested longitudinal cohort study.
Auteurs : Katie Wakeham ; Richard Harding ; Jonathan Levin ; Rosalind Parkes-Ratanshi ; Anatoli Kamali ; David G. LallooSource :
- BMC palliative care [ 1472-684X ] ; 2017.
Abstract
Individuals with HIV have a high prevalence of physical and psychological symptoms throughout their disease course. Despite the clinical and public health implications of unresolved pain and symptoms, little is known about the effect of anti-retroviral therapy (ART) on these outcomes. This study aimed to assess the impact on symptom burden for the year after ART initiation in individuals with a CD4 count <200 cells/uL in Uganda.
DOI: 10.1186/s12904-017-0215-y
PubMed: 28705181
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">The impact of antiretroviral therapy on symptom burden among HIV outpatients with low CD4 count in rural Uganda: nested longitudinal cohort study.</title><author><name sortKey="Wakeham, Katie" sort="Wakeham, Katie" uniqKey="Wakeham K" first="Katie" last="Wakeham">Katie Wakeham</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. katiewakeham@nhs.net.</nlm:affiliation></affiliation></author><author><name sortKey="Harding, Richard" sort="Harding, Richard" uniqKey="Harding R" first="Richard" last="Harding">Richard Harding</name><affiliation><nlm:affiliation>Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Levin, Jonathan" sort="Levin, Jonathan" uniqKey="Levin J" first="Jonathan" last="Levin">Jonathan Levin</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Parkes Ratanshi, Rosalind" sort="Parkes Ratanshi, Rosalind" uniqKey="Parkes Ratanshi R" first="Rosalind" last="Parkes-Ratanshi">Rosalind Parkes-Ratanshi</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Kamali, Anatoli" sort="Kamali, Anatoli" uniqKey="Kamali A" first="Anatoli" last="Kamali">Anatoli Kamali</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Lalloo, David G" sort="Lalloo, David G" uniqKey="Lalloo D" first="David G" last="Lalloo">David G. Lalloo</name><affiliation><nlm:affiliation>Liverpool School of Tropical Medicine, Liverpool, UK.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2017">2017</date><idno type="RBID">pubmed:28705181</idno><idno type="pmid">28705181</idno><idno type="doi">10.1186/s12904-017-0215-y</idno><idno type="wicri:Area/PubMed/Corpus">000B64</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">000B64</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The impact of antiretroviral therapy on symptom burden among HIV outpatients with low CD4 count in rural Uganda: nested longitudinal cohort study.</title><author><name sortKey="Wakeham, Katie" sort="Wakeham, Katie" uniqKey="Wakeham K" first="Katie" last="Wakeham">Katie Wakeham</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. katiewakeham@nhs.net.</nlm:affiliation></affiliation></author><author><name sortKey="Harding, Richard" sort="Harding, Richard" uniqKey="Harding R" first="Richard" last="Harding">Richard Harding</name><affiliation><nlm:affiliation>Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Levin, Jonathan" sort="Levin, Jonathan" uniqKey="Levin J" first="Jonathan" last="Levin">Jonathan Levin</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Parkes Ratanshi, Rosalind" sort="Parkes Ratanshi, Rosalind" uniqKey="Parkes Ratanshi R" first="Rosalind" last="Parkes-Ratanshi">Rosalind Parkes-Ratanshi</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Kamali, Anatoli" sort="Kamali, Anatoli" uniqKey="Kamali A" first="Anatoli" last="Kamali">Anatoli Kamali</name><affiliation><nlm:affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</nlm:affiliation></affiliation></author><author><name sortKey="Lalloo, David G" sort="Lalloo, David G" uniqKey="Lalloo D" first="David G" last="Lalloo">David G. Lalloo</name><affiliation><nlm:affiliation>Liverpool School of Tropical Medicine, Liverpool, UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMC palliative care</title><idno type="eISSN">1472-684X</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Individuals with HIV have a high prevalence of physical and psychological symptoms throughout their disease course. Despite the clinical and public health implications of unresolved pain and symptoms, little is known about the effect of anti-retroviral therapy (ART) on these outcomes. This study aimed to assess the impact on symptom burden for the year after ART initiation in individuals with a CD4 count <200 cells/uL in Uganda.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28705181</PMID><DateCreated><Year>2017</Year><Month>07</Month><Day>14</Day></DateCreated><DateRevised><Year>2017</Year><Month>10</Month><Day>11</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1472-684X</ISSN><JournalIssue CitedMedium="Internet"><Volume>17</Volume><Issue>1</Issue><PubDate><Year>2017</Year><Month>Jul</Month><Day>13</Day></PubDate></JournalIssue><Title>BMC palliative care</Title><ISOAbbreviation>BMC Palliat Care</ISOAbbreviation></Journal><ArticleTitle>The impact of antiretroviral therapy on symptom burden among HIV outpatients with low CD4 count in rural Uganda: nested longitudinal cohort study.</ArticleTitle><Pagination><MedlinePgn>8</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12904-017-0215-y</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Individuals with HIV have a high prevalence of physical and psychological symptoms throughout their disease course. Despite the clinical and public health implications of unresolved pain and symptoms, little is known about the effect of anti-retroviral therapy (ART) on these outcomes. This study aimed to assess the impact on symptom burden for the year after ART initiation in individuals with a CD4 count <200 cells/uL in Uganda.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">HIV-infected, ART-naıve adults referred from voluntary testing and counseling services in rural Uganda for enrollment into a randomized controlled trial to test fluconazole as primary prophylaxis against cryptococcal disease were invited to complete the Memorial Symptom Assessment Scale-Short Form (MSAS-SF) prior to commencing ART and at two subsequent follow up visits. This tool measures self-reported 7-day period prevalence and associated burden of physical and psychological symptoms. Changes in the total number of symptoms and distress indices with time on ART and trial arm were investigated through fitting Linear Mixed Models for repeated measures.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">During the first year of ART initiation the prevalence of most individual symptoms remained constant. The notable exceptions which improved after commencing ART are as follow; prevalence of pain (prevalence changed from 79% to 60%), weight loss (67% to 31%), lack of appetite (46% to 28%), feeling sad (52% to 25%) and difficulty sleeping (35% to 23%). The total number of symptoms and distress indices reduced after treatment commenced. Of concern was that half or more study participants remained with symptoms of pain (60%), itching (57%), skin changes (53%) and numbness in hands and feet (52%) after starting ART. Sixteen symptoms remained with a burden of 25% or more.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Despite the beneficial effect of ART on reducing symptoms, some patients continue to experience a high symptom burden. It is essential that HIV services in sub-Saharan Africa integrate management of symptoms into their programmes.</AbstractText><AbstractText Label="TRIAL REGISTRATION" NlmCategory="BACKGROUND">CRYPTOPRO [ISRCTN 76481529 ], November 2004.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Wakeham</LastName><ForeName>Katie</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda. katiewakeham@nhs.net.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Liverpool School of Tropical Medicine, Liverpool, UK. katiewakeham@nhs.net.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Sussex Cancer Centre, Brighton and Sussex University Hospital, Eastern Road, Brighton, BN2 5DA, UK. katiewakeham@nhs.net.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Harding</LastName><ForeName>Richard</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Department of Palliative Care, Policy & Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Levin</LastName><ForeName>Jonathan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Parkes-Ratanshi</LastName><ForeName>Rosalind</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kamali</LastName><ForeName>Anatoli</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lalloo</LastName><ForeName>David G</ForeName><Initials>DG</Initials><AffiliationInfo><Affiliation>Liverpool School of Tropical Medicine, Liverpool, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>07</Month><Day>13</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Palliat Care</MedlineTA><NlmUniqueID>101088685</NlmUniqueID><ISSNLinking>1472-684X</ISSNLinking></MedlineJournalInfo><CommentsCorrectionsList><CommentsCorrections RefType="Cites"><RefSource>AIDS Behav. 2012 Aug;16(6):1708-15</RefSource><PMID Version="1">21850443</PMID></CommentsCorrections><CommentsCorrections RefType="Cites"><RefSource>J Acquir Immune Defic Syndr. 2010 Aug;54(5):500-5</RefSource><PMID 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RefType="ErratumIn"><RefSource>BMC Palliat Care. 2017 Oct 10;16(1):51</RefSource><PMID Version="1">29017489</PMID></CommentsCorrections></CommentsCorrectionsList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">ART</Keyword><Keyword MajorTopicYN="N">Africa</Keyword><Keyword MajorTopicYN="N">HIV</Keyword><Keyword MajorTopicYN="N">Pain</Keyword><Keyword MajorTopicYN="N">Palliative care</Keyword><Keyword MajorTopicYN="N">Symptom burden</Keyword><Keyword MajorTopicYN="N">Symptom control</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>11</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>06</Month><Day>23</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>7</Month><Day>15</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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