A Cross-Sectional Study on the Assessment and Evaluation of Quality of Life of Human Immunodeficiency Virus and Tuberculosis (HIV- TB) Co-Infected Patients Compared to HIV Infected Patients Using WHOQOL-BREF Questionnaire in a population of the Indian Subcontinent

Hemalatha Selvaraj¹*, Muralikrishnan Dhanasekaran², D. Kumudha³, Kanagaraj Duraisamy⁴

¹Nandha College of Pharmacy, Erode, Tamilnadu, India.

²Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, Alabama, USA

³Department of Pharmacy, Karpagam Academy of Higher Education, Coimbatore, India.

⁴Deputy Director of Medical Services, District TB Centre, Erode, Tamilnadu, India.

Tuberculosis is one of the most common opportunistic infections among people living with HIV (PLHIV) worldwide, particularly in areas with a high tuberculosis prevalence. PLHIV are approximately 17-20 times more likely to develop tuberculosis than HIV-negative individuals. TB-HIV co-infection can have significant pathological (physical and mental) implications and it presents a unique challenge to the quality of life and healthcare professionals. World Health Organization (WHO) defines Quality of Life (QOL) as an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns. Directly Observed Therapy (DOT, (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol) is a popular global approach for the treatment of tuberculosis. Therefore, the current aim of the study was to analyze the quality of life of TB-HIV co-infected patients compared with HIV-infected patients alone and to evaluate the risk factors of TB in HIV patients via the WHOQOL-BREF Questionnaire in the Tamil Language. A cross-sectional study was carried out in the ART clinic of a General Hospital, Erode District in Tamilnadu after the individual patient’s approval to participate in our current study. The study was approved by Institutional Human Ethics Committee (REF: EC/1206/INST/TN/2019). A total of 110 HIV-positive patients (55 TB-positive and 55 TB-negative) were included in this study. The statistical analysis was done by using SPSS version 20.0. A significant difference in the quality of life was observed between the HIV alone and HIV co-infected with TB patients.  Out of the one hundred and ten participants, it was observed that the sixty-eight patients who were undergoing drug therapy (61.80%) were male, and forty-two (38.18%) were female patients. A significant difference has been observed between the two groups in the following areas, physical (p<0.01), physiological (p<0.027), and social relations (p<0.028). Moreover, medication adherence was considerably improved from low to high in the second review to that of their first review. Our study results concluded that regular monitoring of the patient’s adherence to treatment is inevitable to enhance their response to the DOTS (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol) regimen at the initial stage which can improve the patient’s quality of life.

Keywords: Co-infection, HIV, Cross-sectional study, Tuberculosis, WHOQOL-BREF Questionnaire.