P-57 Monitoring quality of life in PLWH using a patient reported outcomes (PRO) and screening tools for emotional and cognitive vulnerability
Bibliographic record
Abstract
Background Recently, the achievements in treatments of people living with HIV (PLWH) have prolonged life expectancy, simplified clinical management and extended time interval between follow-up visits. Thus, some real-life needs may remain undetected during routine attendance, particularly those related to somatic, emotional and cognitive well-being. To optimize the retention-in-care of PLWH to intercept early signs of somatic, emotional and cognitive vulnerability and impairment, a screening program was conducted. Material and Methods All consecutive patients attending at the HIV/AIDS Unit of the San Gallicano Dermatological Institute in Rome, Italy, were administered: i) the Italian version of the Hospital Anxiety and Depression Scale (HADS) to assess anxiety and depression vulnerability; ii) a symptoms scale (PRO), derived from the ISS-Quality of Life (ISSQoL) questionnaire, to measure frequency and intensity of symptoms during the previous month; iii) the Italian version of Montreal Cognitive Assessment (MoCA) to screen cognitive functions in seven different domains. Results From January to March 2024, 126 PLWH on ART were screened. Of these, 112 were men (88.9%) and 14 were women (11.1%), with a median age of 53 (IQR=43.25–58.75) and 47 years (IQR=38–58.25), respectively. Demographic and clinical characteristics are reported in table 1. Almost the totality of patients was virologically supressed and immunologically reconstituted. Overall, 35 (27.77%) and 18 (14.28%) reported anxiety and depression levels above the cut-off score, respectively. At the PRO, 64.8% of the patients declared fatigue at different level of intensity, 55.6% sleep disturbances, 51.6% pain, 34.4% decreased sexual interest, 32.5% mental confusion, and 26.1% erectile dysfunctions. Several reported symptoms were associated with emotional vulnerability for anxiety and depression, particularly fatigue, mental confusion and pain (table 2). Forty-five patients (35.7%) obtained a MoCA total score below the cut-off level of 26/30. Poor performances at MoCA screening were not significantly associated with the time of infection adjusted for age (AOR=1.53;95%CI=0.66–3.55; p=0.08) or with emotional vulnerability (Anx: p=0.41, Dep: p=0.59). Finally, fatigue and pain as PRO tended to be reported from patients on dolutegravir-based (p=0.04) and bictegravir regimen, respectively (p=0.004) (table 3). Conclusions A high proportion of PLWH reports recent somatic symptoms associated with a measurable vulnerability for anxiety and depression and over a third of the patients need a deeper neurocognitive assessment. Although these preliminary findings need to be confirmed at the clinical assessment and in a larger sample, they suggest the value of screening tools to intercept measurable QoL discomfort among viro-immunologically reconstituted PLWH.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".