The impact of combination antiretroviral therapy and its interruption on anxiety, stress, depression and quality of life in thai patients

• Main Authors: Reto Nüesch, Angèle Gayet-Ageron, Ploenchan Chetchotisakd, Wisit Prasithsirikul, Sasisopin Kiertiburanakul, Warangkana Munsakul, Phitsanu Raksakulkarn, Somboon Tansuphasawasdikul, Sineenart Chautrakarn, Kiat Ruxrungtham, Bernard Hirschel, Jintanat Anaworanich, Praphan Phanuphak, Sukontha Saenawat, Saijai Wicharuk, Siriporn Nonenoy, Natnipa Wannachai, Theshinee Chuenyam, Thanthip Nuchapong, Apicha Mahanontharit, Jongkol Sankonte, Bucha Piyavong, Vantanit Piroj, Napawan Seekaow, Wipawan Karakte, Sasiwimol Ubolyam, Suchittra Putthwong, Sirirat Liganonsakul, Wattana Sanchiem, Pongpan Boonchoo, Malee Suannum, Parichat Bunyaprawit, Ratthanant Kaewmarg, Yaowaluk Penglimoon, Sopha Khongsawad
• Other Authors: The HIV Netherlands Australia Thailand Research Collaboration
• Format: Article
• Published: 2018
• Subjects: Immunology and Microbiology; Medicine
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/27656
• Institution: Mahidol University

Objective: Investigation on anxiety, stress, depression, and quality of life (QoL) within STACCATO, a randomised trial of two treatment strategies: CD4 guided scheduled treatment interruption (STI) compared to continuous treatment (CT). Participants: Thai patients with HIV-infection enrolled in the STACCATO trial. Methods: Anxiety, depression assessed by the questionnaires Hospital Anxiety and Depression Scale (HADS) and DASS, stress assessed by the Depression Anxiety Stress Scale (DASS), and QoL evaluated by the HIV Medical Outcome Study (MOS-HIV) questionnaires. Answers to questionnaires were evaluated at 4 time-points: baseline, 24 weeks, 48 weeks and at the end of STACCATO. Results: A total of 251 patients answered the HADS/DASS and 241 answered the MOS-HIV of the 379 Thai patients enrolled into STACCATO (66.2 and 63.6% respectively). At baseline 16.3% and 7.2% of patients reported anxiety and depression using HADS scale. Using the DASS scale, 35.1% reported mild to moderate and 9.6% reported severe anxiety; 8.8% reported mild to moderate and 2.0% reported severe depression; 42.6% reported mild to moderate and 4.8% reported severe stress. We showed a significant improvement of the MHS across time (p=0.001), but no difference between arms (p=0.17). The summarized physical health status score (PHS) did not change during the trial (p=0.15) nor between arm (p=0.45). There was no change of MHS or PHS in the STI arm, taking into account the number of STI cycle (p=0.30 and 0.57) but MHS significant increased across time-points (p=0.007). Conclusion: Antiretroviral therapy improved mental health and QOL, irrespective of the treatment strategy. © Nüesch et al.