PMID- 27454239
OWN - NLM
STAT- MEDLINE
DCOM- 20170707
LR  - 20181202
IS  - 1360-0451 (Electronic)
IS  - 0954-0121 (Linking)
VI  - 29
IP  - 2
DP  - 2017 Feb
TI  - Burden and risk factors for gastrointestinal symptom distress in HIV patients in 
      the modern antiretroviral era.
PG  - 156-167
AB  - In the modern antiretroviral (ARV) era, there is limited knowledge about the 
      prevalence and risk factors for HIV patient-reported gastrointestinal (GI) 
      symptoms (diarrhoea/soft stool, nausea/vomiting, bloating/painful abdomen, loss 
      of appetite, and weight loss/wasting) and distress. We prospectively analysed 
      data (2007-2014) on distressing GI symptoms from the Ontario HIV Treatment 
      Network Cohort Study, which follows people attending HIV clinics. Using 
      generalized estimating equations with a logit link, we estimated the associations 
      of psychosocial, demographic, behavioural, and clinical factors with each GI 
      symptoms compared to asymptomatic and non-bothersome symptoms. Among 1532 
      included participants, 80.4% were male, mean age was 45 years, and 64.6% reported 
      being men who have sex with men. Most were Caucasian (56.3%), a median time since 
      HIV diagnosis of 9.8 years (interquartile range (IQR): 4.1-16.9), and 83.1% were 
      on ARV. More than two-thirds (68.7% (95% confidence intervals (CI): 63.1% to 
      69.2%)) reported one or more symptoms with a median of 1.2 (IQR: 0-1.7). The 
      proportion remained stable over time since HIV diagnosis and ARV initiation. Risk 
      factors varied for multivariable models. A strong association with Centre for 
      Epidemiologic Studies Depression scale scores of >/=23 was found for all symptoms. 
      Adjusted odds ratios (95% CI) were 1.72 (1.39-2.12), 2.95 (2.33-3.72), 2.20 
      (1.81-2.68), 4.97 (3.99-6.19), and 2.98 (2.52-3.82) for diarrhoea, 
      nausea/vomiting, bloating, loss of appetite, and weight loss, respectively. With 
      the exception of bloating, odds were significantly lower for those on ARV 
      containing integrase inhibitors and greater for patients reporting current 
      cannabis use. GI symptoms in the modern ARV era are highly prevalent and may 
      arise as a common pathway of distress in response to psychosocial 
      vulnerabilities, regardless of the stage of diagnosis. These findings support the 
      need for integrated approaches to address psychological and physical distress in 
      HIV disease.
FAU - O'Neill, Tyler J
AU  - O'Neill TJ
AD  - a Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.
AD  - b Ontario HIV Treatment Network , Toronto , Canada.
FAU - Raboud, Janet M
AU  - Raboud JM
AD  - a Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.
AD  - c Toronto General Research Institute, University Health Network , Toronto , 
      Canada.
FAU - Tinmouth, Jill
AU  - Tinmouth J
AD  - a Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.
AD  - d Sunnybrook Research Institute, Sunnybrook Health Sciences Centre , Toronto , 
      Canada.
AD  - e Department of Medicine, Sunnybrook Health Sciences Centre , Toronto , Canada.
FAU - Rourke, Sean B
AU  - Rourke SB
AD  - b Ontario HIV Treatment Network , Toronto , Canada.
AD  - f Department of Psychiatry, University of Toronto , Toronto , Canada.
FAU - Gardner, Sandra
AU  - Gardner S
AD  - a Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.
AD  - b Ontario HIV Treatment Network , Toronto , Canada.
AD  - g Rotman Research Institute, Baycrest , Toronto , Canada.
FAU - Cooper, Curtis
AU  - Cooper C
AD  - h Ottawa Hospital Research Institute, University of Ottawa , Ottawa , Canada.
FAU - Rueda, Sergio
AU  - Rueda S
AD  - i Department of Psychiatry, University of Toronto , Toronto , Canada.
AD  - j Institute for Mental Health Policy Research, Centre for Addiction and Mental 
      Health , Toronto , Ontario , Canada.
FAU - Hart, Trevor A
AU  - Hart TA
AD  - a Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.
AD  - k Department of Psychology , Ryerson University , Toronto , Canada.
FAU - Rachlis, Anita
AU  - Rachlis A
AD  - l Sunnybrook Health Sciences Centre, University of Toronto , Toronto , Canada.
FAU - Burchell, Ann N
AU  - Burchell AN
AD  - a Dalla Lana School of Public Health, University of Toronto , Toronto , Canada.
AD  - m Department of Family and Community Medicine, Faculty of Medicine , University 
      of Toronto , Toronto , Canada.
AD  - n Centre for Urban Health Solutions , Li Ka Shing Knowledge Institute, St. 
      Michael's Hospital , Toronto , Canada.
CN  - OHTN Cohort Study Team
LA  - eng
PT  - Journal Article
DEP - 20160725
PL  - England
TA  - AIDS Care
JT  - AIDS care
JID - 8915313
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (HIV Integrase Inhibitors)
SB  - IM
MH  - Adult
MH  - Anorexia/*epidemiology
MH  - Anti-Retroviral Agents/*therapeutic use
MH  - Female
MH  - HIV Infections/*drug therapy/psychology
MH  - HIV Integrase Inhibitors/therapeutic use
MH  - Humans
MH  - Male
MH  - Marijuana Smoking/epidemiology
MH  - Middle Aged
MH  - Nausea/*epidemiology
MH  - Ontario/epidemiology
MH  - Prevalence
MH  - Prospective Studies
MH  - Risk Factors
MH  - Stress, Psychological/epidemiology
MH  - Vomiting/*epidemiology
MH  - *Weight Loss
OTO - NOTNLM
OT  - HIV
OT  - bloating
OT  - diarrhoea
OT  - gastrointestinal tract
OT  - nausea
OT  - vomiting
OT  - weight loss
EDAT- 2016/07/28 06:00
MHDA- 2017/07/08 06:00
CRDT- 2016/07/26 06:00
PHST- 2016/07/28 06:00 [pubmed]
PHST- 2017/07/08 06:00 [medline]
PHST- 2016/07/26 06:00 [entrez]
AID - 10.1080/09540121.2016.1210076 [doi]
PST - ppublish
SO  - AIDS Care. 2017 Feb;29(2):156-167. doi: 10.1080/09540121.2016.1210076. Epub 2016 
      Jul 25.