Comparison of zidovudine and tenofovir based regimens with regard to health-related quality of life and prevalence of symptoms in HIV patients in a Kenyan referral hospital

Etenyi, Jilian O. and Okalebo, Faith A. and Oluka, Margaret and Sinei, Kipruto A. and Osanjo, George O. and Kurdi, Amanj and Meyer, Johanna C. and Godman, Brian and Opanga, Sylvia (2018) Comparison of zidovudine and tenofovir based regimens with regard to health-related quality of life and prevalence of symptoms in HIV patients in a Kenyan referral hospital. Frontiers in Pharmacology, 9. 984. ISSN 1663-9812

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    Abstract

    Introduction: Zidovudine and tenofovir form the backbone of antiretroviral therapy in Kenya. However, their side-effects may affect the quality of life of patients. Objective: To compare the Health Related Quality of Life (HRQoL) of adult patients on tenofovir versus zidovudine based regimens in a referral hospital in Kenya to provide future guidance. Methods: A comparative cross-sectional study amongst adult out-patients on either tenofovir or zidovudine was undertaken in Kenyatta National Hospital between 2015 and 2016. The Medical Outcome Study HIV Health Survey (MOS-HIV) was administered along with other key aspects of treatment. Linear regression analysis was performed to identify determinants of HRQoL. Results: Patients on zidovudine had a higher Physical Health Summary Score (PHSS) and Mental Health Summary Score (MHSS) compared to those on tenofovir. The presence of any symptom of the disease and a stated inability to cope were negatively associated with PHSS, while having a regular source of income improved PHSS. Being on tenofovir, symptom of illness (β=‐1.24; 95% CI [‐2.253, ‐0.226]), absence of pain (β=0.413; 95% CI [0.152, 0.674]) and patient stated inability to cope with HIV (β=‐1.029; 95% CI [‐1.441, ‐0.617]) affected the MHSS. Patients on tenofovir and second line regimens had more signs and symptoms of illness. Conclusion: Participants on zidovudine based regimens showed a better performance across all aspects of HRQoL. These are considerations for the future