HRQoL in HIV-infected children using PedsQL™ 4.0 and comparison with uninfected children

To assess the reliability and validity of Pediatric Quality of Life Inventory 4.0 (PedsQL(TM) 4.0) in children living with HIV. Also to determine the association of HIV infection, treatment regimens, and type of care received on quality of life (QoL) in pediatric patients. Study was conducted from January to December 2008 at Dr. Ram Manohar Lohia Hospital, New Delhi, India at the HIV pediatric outpatient department (OPD). PedsQL(TM) 4.0 was administered to 100 HIV-infected and 200 uninfected children aged 8-12 years and their primary caregivers. Internal consistency reliability exceeded 0.70 for both proxy-reported and self-reported scales. Intraclass correlation coefficient demonstrated mainly larger values for parent proxy-report (interval of 0.926-0.952 with 95% confidence) than for child self-report (interval of 0.891-0.928 with 95% confidence). Factor analysis was performed and it indicated that five factors were extracted from the PedsQL(TM) 4.0 and these five factors correspond mainly to the five scales. HIV infection was associated with a negative impact on QoL among children with lower scores for physical, school, and emotional functioning and health symptoms. In contrast, uninfected children had lower social functioning scores. Our results showed antiretroviral treatment to be associated with improved QoL among HIV-infected children. We even identified infected children living at home to be at a higher distress of psychosocial functioning and health symptoms when compared with children living in care homes. PedsQL(TM) is an acceptable and valid measure of health-related quality of life (HRQoL) for HIV-infected children and uninfected group. Application of this data will be helpful for program managers to devise care and support programme for both infected and uninfected children.