***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : Investigation on anxiety , stress , depression , and quality of life ( QoL ) within STACCATO , a r and omised trial of two treatment strategies : CD4 guided scheduled treatment interruption ( STI ) compared to continuous treatment ( CT ) . Participants : Thai patients with HIV-infection enrolled in the STACCATO trial . Methods : Anxiety , depression assessed by the  question naires Hospital Anxiety and Depression Scale ( HADS ) and DASS , stress assessed by the Depression Anxiety Stress Scale ( DASS ) , and QoL evaluated by the  HIV Medical Outcome Study ( MOS-HIV ) question naires . Answers to question naires were evaluated at 4 time-points : baseline , 24 weeks , 48 weeks and at the end of STACCATO . Results : A total of 251 patients answered the HADS/DASS and 241 answered the MOS-HIV  of the 379 Thai patients enrolled into STACCATO ( 66.2 and 63.6 % respectively ) . At baseline 16.3 % and 7.2 % of patients reported anxiety and depression using HADS scale . Using the DASS scale , 35.1 % reported mild to moderate and 9.6 % reported severe anxiety ; 8.8 % reported mild to moderate and 2.0 % reported severe depression ; 42.6 % reported mild to moderate and 4.8 % reported severe stress . We showed a significant improvement of the MHS across time ( p=0.001 ) , but no difference between arms ( p=0.17 ) . The summarized physical health status score ( PHS ) did not change during the trial ( p=0.15 ) nor between arm ( p=0.45 ) . There was no change of MHS or PHS in the STI arm , taking into account the number of STI cycle ( p=0.30 and 0.57 ) but MHS significant increased across time-points ( p=0.007 ) . Conclusion : Antiretroviral therapy  improved mental health and QOL , irrespective of the treatment strategy BACKGROUND Zidovudine , the first antiretroviral agent , has short-term haematological toxicity . However , it is unclear whether patients tolerating long-term zidovudine-containing regimens will benefit from a switch to non-zidovudine-containing regimens . METHODS One hundred and fifty-eight patients enrolled in the ALIZE trial receiving zidovudine at baseline were analysed . These patients were r and omized to continue their regimen or to switch to a combination of emtricitabine , didanosine and efavirenz for 48 weeks . Changes from baseline in haemoglobin ( Hb ) , neutrophil and platelet counts were compared between arms as well as the occurrence of cardiovascular events , bacterial infections , use of haematopoietic growth factors , blood transfusion and quality of life using the Medical Outcome Study HIV ( MOS-HIV ) health survey . RESULTS Eighty-one patients continued their regimen and 77 switched . At 48 weeks , mean change from baseline in Hb were + 0.73 and -0.37 g/dL in the switch and maintenance groups , respectively ( P < 0.01 ) . Mean neutrophil counts increased by 592 and 51 cells/mm(3 ) in the switch and maintenance groups , respectively ( P = 0.02 ) . The occurrence of cardiovascular events or bacterial infections was similar in both treatment arms with no use of haematopoietic growth factors or blood transfusion . Also , mean change from baseline in MOS-HIV physical and mental health summary scores was similar in both arms . CONCLUSIONS A switch from a long-st and ing zidovudine- to a non-zidovudine-containing regimen modestly improves haematological parameters and is not associated with obvious clinical benefit Anemia , a common hematological abnormality in HIV , contributes to decreased quality of life ( QOL ) . This study assessed once-every-2-week epoetin alfa on maintaining QOL and hemoglobin ( Hb ) in anemic HIV-infected patients in a 24-week , open-label , multicenter study . HIV-infected patients ( Hb < or = 12 g/dl ) received epoetin alfa 40,000 units subcutaneously once weekly , until reaching Hb > or = 13 g/dl . Patients then entered a maintenance phase ( MP ) , in which epoetin alfa was administered every other week or at longer intervals . The trial objectives were to determine if QOL , as measured by the Medical Outcomes Study -HIV ( MOS-HIV ) general health perceptions ( GHP ) domain and Hb , was maintained . Safety was also assessed . A total of 292 patients were enrolled ( 72 % on HAART ) . Mean baseline laboratory values were Hb = 10.8 g/dl , CD4(+ ) count = 280 cells/microl , and HIV RNA = 51,867 copies/ml . In all , 81 % of patients reached Hb > or = 13 g/dl and 92 % reached Hb > or = 12 g/dl . QOL was maintained from the beginning ( GHP = 44.2 points ) to the end of MP ( GHP = 43.4 points ) with every other week or longer dosing . Mean Hb at the beginning of MP was 13.4 + /- 0.5 g/dl and was 12.8 + /- 1.4 g/dl at study end . Epoetin alfa was well tolerated ; adverse events were consistent with those reported in previous studies of epoetin alfa in HIV-infected patients . Although the clinical approach tested in this study is not consistent with current prescribing recommendations , the results confirm the efficacy of prolonged dosing intervals ( every 2 - 4 weeks ) in maintaining optimal Hb levels and QOL in anemic HIV-infected patients BACKGROUND Antiretroviral therapy including tipranavir boosted with ritonavir ( TPV/r ) has shown superior viral suppression and immunological response compared with comparator ritonavir-boosted protease inhibitor ( CPI/r ) regimens in treatment-experienced HIV-1-infected patients . This study assesses the influence of adverse events ( AEs ) on health-related quality of life ( HRQOL ) and change in HRQOL in patients treated with TPV/r versus CPI/r regimens . METHODS Changes in HRQOL over 48 weeks were assessed using Medical Outcomes Study HIV Health Survey ( MOS-HIV ) data combined from two r and omized , open-label , Phase III studies ( RESIST-1 and RESIST-2 ) . Generalized estimating equations ( GEE ) were used to compare physical health and mental health summary scores and 10 subscale scores , and to compare scores of patients with and without AEs . To compare AE incidences in the two treatment groups , AEs were exposure-adjusted . RESULTS There were 984 patients in the HRQOL analysis .  AE occurrence and severity result ed in significantly lower MOS-HIV scores across both treatment arms ( P<0.05 ) . Overall incidence of AEs was higher in the CPI/r versus TPV/r group ( 562.8 versus 514.4 per 100 patient-exposure years ) ; treatment-related AEs were more frequent in the TPV/r group ( 75.0 versus 56.6 per 100 patient-exposure years ) . HRQOL was maintained in patients on TPV/r over 48 weeks of treatment across all summary and subscale scores . Compared with CPI/r , TPV/r was associated with a significant but small ( SD<0.2 ) improvement in pain scores ( + 4.8 points ; P<0.05 ) . CONCLUSIONS HRQOL was maintained across both summary and all subscale scores from baseline to 48 weeks in the TPV/r and CPI/r treatment arms , despite the incidence of treatment-related AEs Objective : To examine the effect of repeated , long-cycle structured intermittent versus continuous HAART on health-related quality of life ( HRQL ) and symptom distress in patients with chronic HIV infection and plasma HIV RNA of less than 50 copies/ml . Design : Prospect i ve survey of adult patients ( n = 46 ) enrolled in a r and omized clinical trial evaluating intermittent versus continuous HAART on immunological and virologic parameters . Patients ( n = 23 ) r and omized to structured intermittent therapy  received serial cycles of 4 weeks on/8 weeks off HAART . Outcome measures : HRQL was measured by the physical and mental health summary scores of the Medical Outcomes Study HIV Health Survey ( MOS-HIV ) . Symptom distress was measured by the Symptom Distress Scale . Patients completed initial question naires prior to r and omization and at weeks 4 , 12 , and 40 of the trial via a touch screen computer in an outpatient clinic . Results : Baseline demographic and clinical characteristics were equivalent in both treatment groups . Although the mental health summary score declined significantly over time for the structured intermittent group , linear mixed modeling ANOVA indicated no significant difference across time for MOS-HIV summary and Symptom Distress Scale scores between the two treatment arms . Conclusion : In this small sample , repeated long-cycle structured intermittent therapy may not provide HRQL or symptom distress advantage compared to continuous HAART in patients with chronic HIV infection over 10 months of treatment . Further research in a heterogenous chronic HIV population and longer follow-up period is warranted Objective : To investigate the relative magnitude and duration of impact of AIDS-defining events ( ADEs ) and non-AIDS serious adverse events ( SAEs ) on health-related quality of life ( HRQoL ) among patients with advanced HIV/AIDS . Methods : We use data from OPTIMA ( OPTions In Management with Antiretrovirals ) , a multinational , r and omized , open , control , clinical management trial of treatment strategies for patients with multidrug-resistant HIV and advanced immune disease . Longitudinal models were used to determine the effects of ADEs and SAEs on HRQoL across periods before , during , and after event onset . The Medical Outcomes Study HIV Health Survey ( MOS-HIV ) physical and mental health summary scores ( MOS-PHS and MOS-MHS ) , EQ-5D , and the Health Utilities Index Mark 3 HRQoL measures were all assessed at regular follow-up intervals during the trial . Results : ADEs occurred much less frequently than SAEs ( n = 147 vs. n = 821 ) in the study sample population of 368 patients , during median follow-up of 3.96 years . Although both ADEs and SAEs had significant negative impacts on HRQoL , SAEs had at least as large an impact upon HRQoL as ADEs when both were included in a multivariate linear regression model , controlling for other covariates . However , the effect of ADEs on HRQoL was more persistent , with larger magnitude of effect across all instruments in time intervals further from the onset of the event . Conclusions : Non-AIDS SAEs occurring in patients with late-stage HIV/AIDS seem to have at least as important an immediate impact on patient HRQoL as ADEs ; however , the impact of ADEs seems to be more persistent . Our findings call for a greater emphasis on the detection and active prevention of non-AIDS SAEs in patients with late-stage HIV/AIDS This 6-month r and omized controlled trial evaluated the impact on quality of life ( QOL ) of a medication reminder device for patients with HIV . Patients were eligible if they had taken three or fewer highly active antiretroviral therapy ( HAART ) regimens or were treatment naïve . The intervention group received the Disease Management Assistance System ( DMAS ) , a prompting device that verbally reminds patients at medication times and electronically records doses , and a monthly 30 minute adherence educational session . Controls received education only .  QOL was measured at baseline and 6 months using the Centers for Epidemiologic Studies Depression Scale ( CES-D ) , Instrumental Activities of Daily Living ( IADLs ) , and the Medical Outcomes Study HIV Health Survey ( MOS-HIV ) . At baseline , 62 patients completed surveys ( 31 control , 31 DMAS ) ; at month 6 , 48 patients completed surveys ( 23 control , 25 DMAS ) . At month 6 , controls had improved QOL scores for CES-D , IADLs , physical health , general health , pain , QOL , and role functioning , while participants in the DMAS arm had some deterioration in QOL scores . These differences persisted after controlling for demographics , baseline CD4 , and adherence . DMAS was associated with improved adherence but decreased QOL OBJECTIVES Treatment advances have transformed human immunodeficiency virus/acquired immune deficiency syndrome ( HIV/AIDS ) into a chronic manageable disease ; quality of life ( QoL ) has become an important health outcome . Some studies have shown the individual effects of acupuncture and the relaxation response ( RR ) in improving QoL of patients with HIV/AIDS . In light of the presumed shared features of acupuncture and the RR , we conducted a pilot study to examine the effects of adding the RR to usual acupuncture treatment on improving the QoL of HIV/AIDS patients . DESIGN Two-arm double-blind r and omized controlled trial . SETTING S/LOCATION AND SUBJECTS : We enrolled 119 patients with HIV/AIDS ( mean age 46 years , 85 % male ) who had at least 1 of the highly prevalent HIV-related symptoms and who were receiving acupuncture treatment in an acup 
    Output:
    
Conclusions A systematic review of PRO study results showed both the MOS-HIV and EQ-5D were responsive to changes between groups and /or over time in treatment-naïve HIV-infected patients .
These instruments may be used either individually or together in clinical trials to measure changes in HRQL