Objective: The advanced HIV infection carries an important physical, psychological and quality of life deterioration for patients. The introduction of new treatment strategies probably implies a global benefit for HIV patients. We carried out this study in order to know in HIV advanced patients; the clinical situation, the prevalence of psychological alterations (anxiety and depression), the quality of life and the impact of the introduction of new antiretroviral drugs about these variables.
Methods: This is a prospective observational study carried out between January of 1996 and June of 1997 with 52 advanced HIV patients (CD4 cells less than 200/microliter). We carried out 2 clinical interviews with an interval of 12 months being introduced after the first one a change of strategy of antiretroviral treatment. For evaluating the quality of life, the MOS SF-36 was used. The valuation of the anxiety and depression were carried out with the instruments STAI and Beck respectively.
Results: An important physical deterioration was found at the beginning of the study with 84.6% of polisymptomatic patients. We found a high prevalence of anxiety (76.9%) and depression (86.6%) that reaches criteria of graveness respectively in 75% and 25% of the cases. The quality of life was severely affected involving most of the dimensions of the SF-36 scale preserving the social function. The introduction of the change of therapeutic strategy produces a reduction of polisymptomtics patients to 54.8% (p = 0.05), of the graveness of the anxiety (p = 0.009) and depression (p = 0.05) and improving in the perception of general health (p = 0.03) and alterations of physical role (p = 0.02).
Conclusions: The advanced HIV infection carries a high symptomatic load with a high prevalence of psychological dysfunctions and deterioration of the quality of life. The new strategies of HIV treatment induce a global improvement to the patients, but it makes necessary a better management of the psychological dysfunctions.