Quality of life of children and adolescents living with HIV in India: a systematic review and meta-analysis

Children and adolescents living with HIV (CALHIV) encounters compromised health and well-being especially in developing countries. Understanding the health-related quality of life (HRQOL) of CALHIV living in India is vital in planning and developing comprehensive care approach. A systematic review and meta-analysis were conducted to explore and examine the HRQOL of CALHIV in India. Five electronic databases were searched, retrieving 2,729 citations with a final eight studies that met the inclusion criteria. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools. The included studies predominantly evaluated quality of life using the Paediatric Quality of Life Inventory, with a mean self-reported HRQOL score of 77.62 (95% CI 72.91-82.34, I2 = 93%). HRQOL of CALHIV observed to be better than other chronically ill children. However, CALHIV demonstrated lower HRQOL than the matched general population. Younger age children and boys reported better HRQOL. Poor socio-economic status, immunological status and advanced clinical stages noted to be adversely affecting HRQOL. HRQOL of children reared in institutional care reported to better or in par with family reared children. The review highlights the sparse evidence investigating the HRQOL of children with HIV in India, and the need for further well-designed studies in this population. A population-specific holistic-care approach recommended to be benefiting the well-being of CALHIV.