Clinical and quality of life consequences of regimen switching delays in HIV management: a stratified cohort analysis

Health-related quality of life (HRQoL) in people living with HIV/AIDS (PLWHA) is shaped by a combination of HIV-related and non-HIV-related factors, including immunological and virological failure, HIV-associated comorbidities, and antiretroviral therapy (ART)-induced toxicity. Although HRQoL tends to improve during the first year of combination ART (cART), especially among those with advanced HIV, disparities persist. This cross-sectional analytical study assessed HRQoL in 321 PLWHA, of whom 310 were included in the final analysis. HRQoL was evaluated using the EQ-5D-5 L index. Of the participants, 121 (37.7%) had a high EQ-5D-5 L index value of 1, whereas 181 (58.9%) had an index value of less than 1. A statistically significant positive correlation was found between the EQ-5D-5 L index and the recent CD4-T cell count (rs = 0.162, p = .004). Gender-based analysis showed males (0.85 ± 0.15) had significantly higher HRQoL scores compared to females (0.77 ± 0.16). Furthermore, delayed switching to second-line regimens was associated with suboptimal recovery in HRQoL. These findings highlight the importance of timely clinical decisions in switching the ART to a more potent regimen especially in resource poor settings.