The Quality of Well-Being scale in asymptomatic HIV-infected patients

We review applications of the Quality of Well-Being (QWB) scale for use in studies of human immunodeficiency virus (HIV)-infected patients. The QWB scale is a preference-weighted decision theory-based measure that summarizes outcomes in terms of quality-adjusted life years (QALYs). In order to validate the QWB scale for HIV-infected patients, the measure was administered in the University of California, San Diego (UCSD) HIV Neural Behavioral Research Center (HNRC). Data are presented for a cohort of 400 HIV-positive-infected men and 114 HIV-uninfected male controls. The evidence suggests that the QWB scale is a significant prospective predictor of mortality. The QWB scale was concurrently associated with the number of CD4+ lymphocytes and ratings of neurological impairment based upon clinical evaluations. Further, the QWB scale was related to neuropsychological assessments derived from formal tests of cognitive functioning. Neuropsychological impairments may be associated with income loss for affected patients. The QWB scale scores were lower among patients with clinical depression. We conclude that the QWB scale is an appropriate general health outcome measure for use in observational studies and clinical trials for patients with HIV disease.