PMID- 18494750
OWN - NLM
STAT- MEDLINE
DCOM- 20090729
LR  - 20090715
IS  - 1524-4733 (Electronic)
IS  - 1098-3015 (Linking)
VI  - 11
IP  - 7
DP  - 2008 Dec
TI  - A predictive model of health state utilities for HIV patients in the modern era 
      of highly active antiretroviral therapy.
PG  - 1144-53
LID - 10.1111/j.1524-4733.2008.00326.x [doi]
AB  - OBJECTIVE: Existing estimates of human immunodeficiency virus (HIV)-related 
      health state utilities are inadequate for comparing alternative treatments on the 
      basis of regimen-specific attributes such as dosing requirements or tolerability. 
      The objective of this study was to examine the marginal impact of dosing, adverse 
      events (AEs), and other factors on patients' health state utilities. METHODS: 
      Treatment naive and experienced HIV patients participating in five open-label 
      trials of highly active antiretroviral therapy (HAART) completed the 36-Item 
      Short Form Health Survey (SF-36) instrument at various time points. SF-36 
      responses were converted to utilities using a previously reported algorithm. 
      Expected utilities were estimated as a function of patient demographics, regimen 
      attributes, disease status, and AEs using a mixed-effects maximum likelihood 
      model. Mean utilities for five HIV health states were derived from predicted 
      patient utilities. RESULTS: Negative predictors of utility included greater age 
      (-0.001), prior acquired immune deficiency syndrome-defining events (-0.036), 
      female gender (-0.038), and injection drug use (-0.056; P < 0.01 for all). 
      Utility also depended on CD4+ cell count (P < 0.01), but not the presence of 
      undetectable viral load. Regimen attributes were marginally associated with 
      changes in utility. Depression was associated with the largest decrease in 
      utility (-0.054, P < 0.001) among the AEs examined. Using the model to generate 
      predicted utilities from the sample provided mean estimates ranging from 0.742 
      (SD 0.058) to 0.798 (0.052) for CD4+ counts between 0 and 99 and > or =500 
      cells/mm(3), respectively. CONCLUSIONS: HIV patients' health-related quality of 
      life may be substantially affected by clinically relevant patient-, disease-, and 
      treatment-related factors, such as injection drug use, disease status, food/drink 
      restrictions, and AEs.
FAU - Kauf, Teresa L
AU  - Kauf TL
AD  - Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University 
      of Florida, Gainesville, FL 32610-0496, USA. tkauf@ufl.edu
FAU - Roskell, Neil
AU  - Roskell N
FAU - Shearer, Arran
AU  - Shearer A
FAU - Gazzard, Brian
AU  - Gazzard B
FAU - Mauskopf, Josephine
AU  - Mauskopf J
FAU - Davis, E Anne
AU  - Davis EA
FAU - Nimsch, Christopher
AU  - Nimsch C
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20080520
PL  - United States
TA  - Value Health
JT  - Value in health : the journal of the International Society for Pharmacoeconomics 
      and Outcomes Research
JID - 100883818
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - *Antiretroviral Therapy, Highly Active
MH  - Female
MH  - HIV Infections/*drug therapy/*psychology
MH  - *Health Surveys
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - *Quality of Life
MH  - Severity of Illness Index
MH  - Substance-Related Disorders
MH  - Viral Load
MH  - Young Adult
EDAT- 2008/05/23 09:00
MHDA- 2009/07/30 09:00
CRDT- 2008/05/23 09:00
PHST- 2008/05/23 09:00 [pubmed]
PHST- 2009/07/30 09:00 [medline]
PHST- 2008/05/23 09:00 [entrez]
AID - S1098-3015(10)60596-7 [pii]
AID - 10.1111/j.1524-4733.2008.00326.x [doi]
PST - ppublish
SO  - Value Health. 2008 Dec;11(7):1144-53. doi: 10.1111/j.1524-4733.2008.00326.x. Epub 
      2008 May 20.