Simoni Jane M, Yard Samantha S, Huh David
Department of Psychology, University of Washington, Seattle, USA.
AIDS Care. 2013;25(2):181-5. doi: 10.1080/09540121.2012.687821. Epub 2012 May 29.
Knowing at antiretroviral therapy (ART) initiation which patients might be at greatest risk for failure to achieve viral suppression would enable providers to target patients most in need and tailor their care appropriately. This study involved multilevel modeling of data from a randomized controlled trial among outpatients in Seattle, WA, USA. The 224 participants initiating or switching ART at baseline were 24% female, 34% heterosexual, and 47% Caucasian. Of 24 baseline demographic and psychosocial patient-level variables modeled in separate generalized estimating equations, only employment predicted changes in HIV-1 RNA viral load or CD4 lymphocyte count over the course of the 9-month trial. Although the findings require replication, they suggest adherence support strategies should emphasize close monitoring and support for all patients initiating ART.
在开始抗逆转录病毒疗法（ART）时，了解哪些患者最有可能无法实现病毒抑制，将使医疗服务提供者能够确定最需要治疗的患者，并为他们提供适当的个性化护理。本研究对美国华盛顿州西雅图市门诊患者的一项随机对照试验数据进行了多层次建模。在基线时开始或转换抗逆转录病毒疗法的224名参与者中，24%为女性，34%为异性恋，47%为白种人。在单独的广义估计方程中对24个基线人口统计学和社会心理患者层面变量进行建模，在为期9个月的试验过程中，只有就业情况能够预测HIV-1 RNA病毒载量或CD4淋巴细胞计数的变化。尽管这些发现需要重复验证，但它们表明，依从性支持策略应强调对所有开始抗逆转录病毒疗法的患者进行密切监测和支持。
