Health-Related Quality of Life Among HIV-Infected Children and Its Association With Socio-Demographic, Clinical and Nutritional Variables: A Comparative Approach

Chinyere G Ogbonna-Nwosu; Kenechukwu K Iloh; Justus U Onu; Ifeanyi F Nwosu; Ngozi Ibeziako; Nnamdi Onyire; Dorathy C Obu; Chukwunonso A Nwosu; Nneka C Ezeudemba; Cynthia U Ifejika

doi:10.7759/cureus.25222

Health-Related Quality of Life Among HIV-Infected Children and Its Association With Socio-Demographic, Clinical and Nutritional Variables: A Comparative Approach

Cureus. 2022 May 22;14(5):e25222. doi: 10.7759/cureus.25222. eCollection 2022 May.

Authors

Affiliations

¹ Pediatrics and Child Health, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, NGA.
² Pediatrics and Child Health, University of Nigeria, Enugu, NGA.
³ Psychiatry, Nnamdi Azikiwe University, Nnewi, NGA.
⁴ Child and Adolescent Mental Health, Federal Neuropsychiatric Hospital, Enugu, NGA.
⁵ Internal Medicine, Maimonides Medical Center, Brooklyn, USA.
⁶ Epidemiology and Public Health, Kaonic Research LLC, Gaithersburg, USA.
⁷ Infectious Disease, Medical University of Silesia, Katowice, POL.
⁸ Hematology and Medical Oncology, Emory University Winship Cancer Institute, Atlanta, USA.

Abstract

Background: The human immunodeficiency virus (HIV) infection and its treatment impact the child's life as well as that of their caregivers. As therapeutic advances are made in the field, improved survival has shifted the focus from morbidity and mortality to quality of life. This study aims to compare the health-related quality of life (HRQoL) of children living with HIV in comparison with an HIV-negative control group and determine its relationship with socio-demographic, clinical, and nutritional variables.

Method: This was a multi-center cross-sectional comparative study involving 274 participants (137 per group) carried out in tertiary and secondary level healthcare facilities in Nigeria. Socio-demographic, clinical, and nutritional variables were obtained using a researcher-designed data collection sheet. HRQoL was measured using the Paediatrics Quality of Life Inventory (PedsQL 4.0), while caregivers' burden was assessed using the Zarit-Burden Interview (ZBI). A comparison of the health-related quality of life of the cases and the control group was done using an independent t-test. The predictors of HRQoL among the cases were measured using multivariate stepwise linear regression analysis.

Result: The overall health-related quality of life of HIV-infected children and those of the HIV-negative control group were similar. However, there was a significant difference in the school and psychosocial functioning domains between the two groups with HIV-positive children scoring lower in these domains. For HIV-positive children, being from upper social class (p = 0.01, R² = 0.098), male gender (p = 0.005, R² = 0.063), higher scores in the caregiver burden scale (p = 0.009, R² = 0.150) and more disease severity (p < 0.001, R² = 0.321) were significant predictors of lower health-related quality of life.

Conclusion: The findings of this study show that the overall health-related quality of life of HIV-positive children was similar to that of age- and sex-matched HIV-negative control group. This finding gives clinicians some optimism that with adequate treatment, HIV-positive children will have better outcomes not only in mortality but in psychosocial variables such as quality of life. In addition, the finding on the relationship between caregiver burden and HRQoL underscores the need to focus on family-based interventions to improve the burden of caregiving on family members involved in the care of HIV-positive children.

Keywords: caregivers' burden; clinical and nutritional variables; health-related quality of life; hiv infection; socio-demographic.