Arabic Translation and Adaptation of the CVID_QoL Questionnaire to Measure Health-RelatedQuality of Life of Adultswith Common Variable Immune Deficiency

##plugins.themes.academic_pro.article.sidebar##

Published Mar 10, 2026
https://doi.org/10.62438/tunismed.v104i01.5835
Download
PDF
Vol. 104 No. 01 (2026): Tunis Med Jan 2026

##plugins.themes.academic_pro.article.main##

Salim Zridi
Laboratory of Clinical Immunology, Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Abderrahmane Errami
Laboratory of Clinical Immunology, Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco.
Leila Barakat
Internal Medicine Department, CHU Ibn Rochd, Casablanca Morocco
https://orcid.org/0009-0005-8759-8424
Mina Moudatir
Laboratory of Clinical Immunology, Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Internal Medicine Department, CHU Ibn Rochd, Casablanca Morocco
Ahmed Aziz Bousfiha
Laboratory of Clinical Immunology, Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Department of pediatric infectious and immunological diseases, Abderrahim El Harouchi Children Hospital, University Hospital Center Ibn Rochd, Casablanca, Morocco
Ibtihal Benhsaien
Laboratory of Clinical Immunology, Inflammation and Allergy (LICIA), Faculty of Medicine and Pharmacy, Hassan II University, Department of pediatric infectious and immunological diseases, Abderrahim El Harouchi Children Hospital, University Hospital Center Ibn Rochd, Casablanca, Morocco
https://orcid.org/0000-0001-5727-9629

Abstract

Introduction:
Common Variable Immune Deficiency (CVID) is the most frequent symptomatic inborn error of immunity, associated with recurrent infections, autoimmunity, and malignancy. These complications substantially impair health-related quality of life (HRQoL). To date, no disease-specific HRQoL instrument has been validated in Arabic. This study aimed to translate, culturally adapt, and validate the CVID_QoL questionnaire for Arabic-speaking patients.


Methods: The CVID_QoL was translated and adapted into Arabic according to international cross-cultural guidelines. A pilot test was performed, followed by administration of the pre-final version to 20 adults with CVID at Abderrahim El Harouchi Hospital, Casablanca. Internal consistency was assessed using Cronbach’s alpha, and test–retest reliability with intraclass correlation coefficients (ICC). Construct validity was evaluated through Pearson’s correlations with the General Health Questionnaire-12 (GH-12) and the Short Form-36 (SF-36). Discriminant validity was tested using the Mann–Whitney U test across clinical subgroups.


Results: The Arabic CVID_QoL showed high internal consistency (Cronbach’s α = 0.91) and excellent test–retest reliability (ICC = 0.88). Convergent validity was confirmed by significant correlations between CVID_QoL domains and GH-12 and SF-36 scores (e.g., emotional functioning with SF-36 mental health, r = 0.65, p< 0.001). Discriminant validity was established by significantly lower scores among patients with recurrent infections, pulmonary complications, or autoimmunity (p< 0.05).


Conclusion: The Arabic CVID_QoL is a reliable and valid tool for measuring HRQoL in Arabic-speaking adults with CVID. It provides a valuable contribution for both clinical care and research. Larger, multicenter studies are recommended to further confirm its utility.

Keywords:

Common Variable Immunodeficiency, Primary Immunodeficiency, Health-Related Quality of Life (HRQoL), Adults HRQoL, CVID_QoL

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Quinti I, Pulvirenti F, Giannantoni P, Hajjar J, Canter D, Milito C, et al. Development and initial validation of a questionnaire to measure health-related quality of life of adults with Common Variable Immune Deficiency: The CVID_QoL questionnaire. J Allergy Clin Immunol Pract. 2016;4(6):1169–79.e4. doi:10.1016/j.jaip.2016.07.012.
  2. Andersen LK, Lima M, Risstad H, Aass HC, Fevang B. Measuring quality of life of primary antibody deficiency patients using a disease-specific health-related quality of life questionnaire for common variable immunodeficiency (CVID_QoL). J Clin Immunol. 2019;39(2):182–92. doi:10.1007/s10875-019-0597-7.
  3. Eyice D, Ceylan E, Serbes M, Tufan A, Arslan IB, Soyer ÖU, et al. Validity and reliability of the Turkish version of the quality-of-life questionnaire in adult patients with common variable immunodeficiency. Asthma Allergy Immunol. 2024;22(2):85–93.
  4. Aaronson N, Ahmedzai SH, Bergman B, Bullinger M, Cull A, Duez N, et al. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76. doi:10.1093/jnci/85.5.365.
  5. Breslin S. Quality of life: how is it measured and defined? Soz Praventivmed. 1991;46(3):246–51. doi:10.1159/000282146.
  6. Buco CEAM, Buenviaje KAC, Bulan RBC, Cabaña RJL, Cabuhat MKS, Bongar MVV, et al. Developing and testing a model of quality of life among chronically-ill, community-dwelling older adults: a structural equation model. Arch Gerontol Geriatr. 2018;78:261–8. doi:10.1016/j.archger.2018.07.013.
  7. Pollo CF, Meneguin S, Miot HA. Evaluation instruments for quality of life related to melasma: an integrative review. Clinics (Sao Paulo). 2018;73:e65. doi:10.6061/clinics/2018/e65.
  8. Yadav A, Garg T, Mandal AK, Chander R. Quality of life in patients with acquired pigmentation: an observational study. J Cosmet Dermatol. 2018;17(6):1293–4. doi:10.1111/jocd.12686.
  9. Bousfiha AA, Jeddane L, Picard C, Al-Herz W, Ailal F, Chatila TA, et al. Human inborn errors of immunity: 2019 update of the IUIS phenotypical classification. J Clin Immunol. 2020;40(1):66–81. doi:10.1007/s10875-020-00758-x.
  10. Tangye SG, Al-Herz W, Bousfiha AA, Chatila TA, Cunningham-Rundles C, Etzioni A, et al. Human inborn errors of immunity: 2019 update on the classification from the International Union of Immunological Societies Expert Committee. J Clin Immunol. 2020;40(1):24–64. doi:10.1007/s10875-019-00737-x.
  11. Moundir A, Ouair H, Benhsaien I, Jeddane L, Rada N, Amenzoui N, et al. Genetic diagnosis of inborn errors of immunity in an emerging country: a retrospective study of 216 Moroccan patients. J Clin Immunol. 2022;43(2):485–94. doi:10.1007/s10875-022-01398-z.
  12. Silva NRD, Gunawardena S, Rathnayake D, Wickramasingha GD. Spectrum of primary immunodeficiency disorders in Sri Lanka. Allergy Asthma Clin Immunol. 2013;9(1):50. doi:10.1186/1710-1492-9-50.
  13. Rababa M, Al-Sabbah S, Zahra TA. Importance of pain assessment, documentation, and education among nurses caring for critically ill patients: a cross-sectional study. Eur J Gen Med. 2023;20(5):em510. doi:10.29333/ejgm/13292.
  14. Quinti I, Pulvirenti F, Giannantoni P, Hajjar J, Canter D, Milito C, et al. Development and Initial Validation of the CVID_QoL Questionnaire. J Allergy Clin Immunol Pract. 2016;4(6):1169–79.e4. doi:10.1016/j.jaip.2016.07.012.
  15. Aaronson N, Ahmedzai SH, Bergman B, Bullinger M, Cull A, Duez N, et al. The EORTC QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85(5):365–76.
  16. Al-Ghimlas F, Al-Omran M, Guyatt G. Linguistic validation of the Chronic Respiratory Disease Questionnaire in an Arabic-speaking population. Respiration. 2011;82(4):387–9. doi:10.1159/000324874.
  17. Barros E, Alexandre NMC. Cross-cultural adaptation of the Nordic musculoskeletal questionnaire. Int Arch Occup Environ Health. 2003;76(8):623–8. doi:10.1007/s00420-003-0434-0.
  18. Arini M, Setyonugroho W, Permana I, Dewi A, Hilman O, Ahmad RA, et al. The cross-cultural adaptation for assessment of chronic illness care questionnaire into Indonesian version. Asia Pac J Public Health. 2021;33(5):627–31. doi:10.1177/10105395211018090.
  19. Kleijn WC, Hovens JE, Rodenburg J. Posttraumatic stress symptoms in refugees: assessments with the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist–25 in different languages. Psychol Rep. 2001;88(2):527–32. doi:10.2466/pr0.2001.88.2.527.
  20. Poli MC, Aksentijevich I, Bousfiha AA, et al. Human inborn errors of immunity: 2024 update on the phenotypic classification from the International Union of Immunological Societies Expert Committee. J Hum Immunol. 2025;1(1):e20250002. doi:10.70962/jhi.20250002.