By Michael Greer

AIDS Weekly 12 March 2001

Researchers in New York have questioned the ability of highly active antiretroviral therapy (HAART) to improve quality of life for HIV patients.

J.R. Brechtl and colleagues found that even when HAART was effective at improving the physical well being of patients, the treatment regimen had little effect on the quality of their extended life.

HAART's ability to improve immune function and viral load have been well characterized, but few studies have tried to measure the impact of such treatment on psychological health, noted Brechtl et al. at the Terence Cardinal Cooke Health Care Center.

Studying patients at a palliative care center, the researchers collected information about pain and symptom severity, depression, and psychosocial function for their report in the Journal of Pain and Symptom Management.

While depression was alleviated to a significant degree by HAART, other factors - particularly pain severity - were barely or not at all improved by treatment, study data showed.

Overall, patients did not feel as though their quality of life was improved by HAART therapy, even when clinically successful ("The use of highly active antiretroviral therapy (HAART) in patients with advanced HIV infection: Impact on medical, palliative care, and quality of life outcomes," J Pain Symptom Manage, 2001;21(1):41-51).

Treatment failure, either intolerance or death, occurred in up to 40% of the patients studied.

"Despite [physical] improvements, the benefits of treatment on pain and symptom distress, and psychological well-being were less clear," Brechtl et al. concluded. "Further research is clearly necessary to better understand the benefits of HAART therapy in patients with advanced HIV infection."

The corresponding author for this report is J.R. Brechtl, Terence Cardinal Cooke Health Care Center, Dept. of Medicine, 1249 5th Avenue, New York, NY 10029, USA.

Key points reported in this study include:

* HAART treatment does not appear to have significant benefits for the mental health of HIV patients

* Patients did not report a quality of life improvement after HAART

* This was true even when the treatment regimen was clinically successful