Persons living with human immunodeficiency virus (HIV) are living longer and therefore are more likely to suffer significant morbidity due to potentially treatable liver diseases. Liver diseases alone have been shown to have a significant negative effect on one's health-related quality of life (HRQOL). Clinical evidence suggests that persons living with HIV and liver disease, a growing number of individuals, may have a poorer HRQOL than persons living with HIV who do not have liver disease. Thus, this study examined the multiple components of HRQOL by testing Wilson and Cleary's model in persons with HIV and in persons living with HIV and liver disease using structural equation modeling. This secondary analysis used de-identified baseline and medical record review data from a parent study testing interventions to improve medication adherence in persons living with HIV (R01 NR04749). The Wilson and Cleary model components include: biological/physiological factors (HIV viral load, CD4 counts), symptom status (Beck Depression Inventory II, Medical Outcomes Study HIV Health Survey [MOS-HIV] mental function), functional status (missed appointments, MOS-HIV physical function), general health perceptions (Perceived burden visual analogue scale, MOS-HIV health transition), and overall QOL (Satisfaction with Life Scale, MOS-HIV overall QOL). Characteristics of the individual and environment were also explored. The Wilson and Cleary (1995) model was found to be useful in linking clinical indicators to patient-related outcomes. The findings provide the foundation for development and future testing of a targeted bio-behavioral nursing intervention to improve HRQOL in persons living with HIV and liver disease
