Health-related quality of life trajectories during analytical treatment interruptions in HIV cure-related studies and the influence of depression, anxiety, and resilience

Background Although analytical treatment interruptions (ATIs) protocols are essential for evaluating the efficacy of HIV cure-related interventions, little is known about how their health-related quality of life (HRQOL) changes when undergoing these trial requirements.Objective This study evaluated how HRQOL evolved over time among people with HIV (PWH) participating in HIV cure-related studies requiring ATIs and examined the role of baseline depressive symptoms, anxiety, and resilience in shaping these trajectories.Methods Seventeen PWH were included. Our analysis included data from two HIV cure-related studies involving ATIs: the UCSF SCOPE-ATI Study and the UCSF-amfAR Combination Trial. HRQOL was measured at baseline, pre-ATI, medication restart, and study completion. Baseline depressive symptoms, trait-based anxiety, and resilience were assessed using validated scales. Frequentist and Bayesian Linear mixed-effects models evaluated changes in HRQOL, the influence of baseline psychosocial factors, and potential moderating effects.Results In frequentist models, HRQOL significantly improved over time (β = 0.63, p = .016). Baseline depressive symptoms (β = −1.00, p = .048) and anxiety (β = −1.18, p = .001) were negatively associated with HRQOL, indicating that higher levels of these factors were linked to lower HRQOL. Resilience moderated improvements in HRQOL over time (time*resilience β = 0.36, p = .040), with higher baseline resilience associated with steeper increases in HRQOL.Conclusions HRQOL improved over time in this sample despite ATI participation requirements. Findings underscore the need to address psychosocial factors, particularly depressive symptoms and anxiety, in HIV cure-related studies to optimize participant well-being and enhance the overall study experience.