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Gastrointestinal Symptoms in HIV Dis...

O'Neill, Tyler J.

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Gastrointestinal Symptoms in HIV Disease: Results from the Ontario HIV Treatment Network Cohort Study, 2007 TO 2014.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Gastrointestinal Symptoms in HIV Disease: Results from the Ontario HIV Treatment Network Cohort Study, 2007 TO 2014./
Author:	O'Neill, Tyler J.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2018,
Description:	249 p.
Notes:	Source: Dissertations Abstracts International, Volume: 80-02, Section: B.
Contained By:	Dissertations Abstracts International80-02B.
Subject:	Biostatistics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=10743129
ISBN:	9780438186859

Gastrointestinal Symptoms in HIV Disease: Results from the Ontario HIV Treatment Network Cohort Study, 2007 TO 2014.
O'Neill, Tyler J.

Gastrointestinal Symptoms in HIV Disease: Results from the Ontario HIV Treatment Network Cohort Study, 2007 TO 2014. - Ann Arbor : ProQuest Dissertations & Theses, 2018 - 249 p.

Source: Dissertations Abstracts International, Volume: 80-02, Section: B.

Thesis (Ph.D.)--University of Toronto (Canada), 2018.

This item must not be sold to any third party vendors.

Patient-reported gastrointestinal (GI) symptoms (diarrhea, nausea/vomiting, bloating, loss of appetite, weight loss/wasting) were explored among 1826 people living with HIV enrolled in the Ontario HIV Treatment Network Cohort Study, from 2007 to 2014. At first annual questionnaire, participants had a median age of 45 years, 64% were men who have sex with men, 56% Caucasian, were diagnosed with HIV for 10 years, on average, with 82% on combination antiretroviral therapy (cART), 78% undetectable viral load (<50 copies/mL), and a mean CD4-positive cell count of 468 cells/mm3. Participants rated GI symptom experience and distress from 0 ('don't have symptom') to 4 ('have symptom, bothers me a lot'). Prevalence of one or more GI symptoms was 68% and greatest for bloating/painful abdomen (41%) and diarrhea (40%), followed by loss of appetite (25%), nausea/vomiting (21%), and weight loss (21%). Generalized estimating equation (GEE) models with a logit link estimated odds ratios of distressing (scores 2 to 4) versus no or non-distressing symptoms (scores 0 to 1). In adjusted models, risk of depression was consistently associated with greater odds of distressing symptoms. Generalized linear mixed models (GLMMs) estimated associations between GI symptoms (score 0, referent) and health-related quality of life (HRQOL). Symptoms were associated with clinical impairment of HRQOL. All symptom distress scores 2 to 4 were associated with lower mental HRQOL compared to those without GI symptoms (score 0) in adjusted models. Loss of appetite scores ≥1, ≥2 for diarrhea, nausea/vomiting, and bloating and ≥3 for weight loss were independently associated with lower physical HRQOL. Finally, no significant associations between the impact of GI symptoms (score 0, referent) on detectable viral load directly or indirectly through cART non-adherence were detected from GEE models with a logit link. GI symptoms continue to burden HIV patients despite modern clinical care in Ontario. Opportunities exist for enhanced clinical care. Knowledge of specific etiologies and causal mechanisms of GI symptoms are necessary to further understand their impact in HIV disease.

ISBN: 9780438186859Subjects--Topical Terms:

1002712
Biostatistics.

Gastrointestinal Symptoms in HIV Disease: Results from the Ontario HIV Treatment Network Cohort Study, 2007 TO 2014.
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520 $a Patient-reported gastrointestinal (GI) symptoms (diarrhea, nausea/vomiting, bloating, loss of appetite, weight loss/wasting) were explored among 1826 people living with HIV enrolled in the Ontario HIV Treatment Network Cohort Study, from 2007 to 2014. At first annual questionnaire, participants had a median age of 45 years, 64% were men who have sex with men, 56% Caucasian, were diagnosed with HIV for 10 years, on average, with 82% on combination antiretroviral therapy (cART), 78% undetectable viral load (<50 copies/mL), and a mean CD4-positive cell count of 468 cells/mm3. Participants rated GI symptom experience and distress from 0 ('don't have symptom') to 4 ('have symptom, bothers me a lot'). Prevalence of one or more GI symptoms was 68% and greatest for bloating/painful abdomen (41%) and diarrhea (40%), followed by loss of appetite (25%), nausea/vomiting (21%), and weight loss (21%). Generalized estimating equation (GEE) models with a logit link estimated odds ratios of distressing (scores 2 to 4) versus no or non-distressing symptoms (scores 0 to 1). In adjusted models, risk of depression was consistently associated with greater odds of distressing symptoms. Generalized linear mixed models (GLMMs) estimated associations between GI symptoms (score 0, referent) and health-related quality of life (HRQOL). Symptoms were associated with clinical impairment of HRQOL. All symptom distress scores 2 to 4 were associated with lower mental HRQOL compared to those without GI symptoms (score 0) in adjusted models. Loss of appetite scores ≥1, ≥2 for diarrhea, nausea/vomiting, and bloating and ≥3 for weight loss were independently associated with lower physical HRQOL. Finally, no significant associations between the impact of GI symptoms (score 0, referent) on detectable viral load directly or indirectly through cART non-adherence were detected from GEE models with a logit link. GI symptoms continue to burden HIV patients despite modern clinical care in Ontario. Opportunities exist for enhanced clinical care. Knowledge of specific etiologies and causal mechanisms of GI symptoms are necessary to further understand their impact in HIV disease.
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