Quality of Life Among People Living With HIV in England and the Netherlands Comparable to the General Population

Introduction: Nowadays, HIV is a chronic condition with a similar life expectancy as the general population. Consequently, improving and ensuring a good health-related quality of life (HrQoL) among people living with HIV (PLWH) is increasingly important and has risen on the global agenda in recent years. A ‘fourth 90’ as 90% of people with viral load suppression have a good HrQoL should therefore be adopted alongside the other 90-90-90 targets. This study aims to report the progress on HrQoL as the ‘fourth 90’ and compare against the general population in the Netherlands and England. Methods: In the Netherlands, individuals attending the HIV outpatient clinic of a tertiary hospital were asked to complete the EQ-5D-5L from June 2016 until December 2018. In England, individuals attending one of 73 HIV outpatient clinics were randomly sampled to complete the Positive Voices survey, which included the EQ-5D-5L, from January to September 2017. HrQoL scores were combined with demographic data and compared to general population data. Findings: The EQ-5D-5L was filled-out by 895 PLWH in the NL and 4,137 in England. HrQoLutility was 0.85 among Dutch and 0.83 among English PLWH. This equated to 98% and 94% of the general population HrQoLutility in the Netherlands and England, respectively. Of the EQ-5D domains, anxiety/depression was mostly affected, with one-third in Dutch (35%) and almost half (47%) of English PLWH reporting symptoms. This was significantly higher compared to their respective general populations (21% NL and 31% England). Interpretation: Overall, HrQoLutility for PLWH was high in both countries and highly comparable to the general populations Nevertheless, focus on anxiety and depression should be increased. The EQ-5D-5L proved an easy HrQoL measurement tool and identified areas for improvement by social and behavioural interventions. Funding Statement: The study received funding (unrestricted grants) from: Gilead sciences, ViiV Healthcare, MSD and MSD, Janssen pharmaceuticals. Declaration of Interests: SP reports an unrestricted educational grant from Gilead Sciences; DvdV reports unrestricted research grant from Gilead Sciences, MSD, ViiV and Janssen Pharmaceuticals; CAB reports personal fees from speaker honoraria from ViiV outside the submitted work; AvS reports grants from Dutch Ministry of Health, Welfare and Sport, during the conduct of the study; grants from European Centre for Disease Prevention and Control, outside the submitted work. MV: Dr. Versteegh reports grants from ZonMW, grants from EuroQoL Research Foundation, during the conduct of the study; grants from EuroQoL Research Foundation, outside the submitted work; MK, ES, BN, LV, VD, AV have nothing to disclose. Ethics Approval Statement: The Netherlands study was reviewed and approved by the local Medical Ethics Committee (MEC-2016-264). Additionally, all participants were asked to sign an informed consent form and all data were anonymized. The England study was reviewed and approved by the London – Harrow Research Ethics Committee (13/LO/0279).