Association Between Quality of Life and Viral Load Among People With HIV in the Current Antiretroviral Era

OBJECTIVES: Quality of life (QoL) has become the 4^th pillar of the UNAIDS strategic program. Due to a lack of contemporary data on QoL in people living with HIV/AIDS (PHW), this study aimed to synthesize the literature on the association of viral load (VL) and QoL among PWH in the current antiretrovial therapy era.

METHODS: Embase, PsycINFO, and PubMed databases were searched in January 2023 to identify studies that evaluated QoL and AL among PWH for studies published between 2000 and 2022 in English. We consolidated the findings on the association of VL and QoL and summarized characteristics of the selected articles.

RESULTS: Eighty-one articles were included in our final analysis from the screening step and duplicate removal. Eighty percent (65/81) of the articles reported conclusive findings on the association between QoL and VL. These 65 articles studied a total of 26,329 patients (min – max: 24–1668 per article) of diverse geographics. The most common QoL measures was MOSHIV (12/65), followed by WHOQoL-HIV-BREF (11/65), and SF-36 (9/65). The largest study (N=1668) was composed of U.S. military personnel. Several articles reported conclusive findings on the association between QoL and VL studying mixed populations (i.e., cross countries). Sixty percent (39/65) of these articles reported a statistically significant association between QoL (or some subscales of the QoL measure) and VL while the remaining 26 articles reported no association. Another 16 articles (16/81) were inconclusive about the association between QoL and VL. One of the greatest challenges in studying QoL among PWH is loss to follow up.

CONCLUSIONS: Additional data is needed on the association between VL and QoL in several important generalizable settings. Particularly, future studies utilizing (trans)national HIV network data using consensus QoL instruments will have a high yield of affirming such association.