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巴西巴伊亚州萨尔瓦多市成人艾滋病患者在抗逆转录病毒治疗头六个月中与治疗依从性不佳相关的因素。

Factors associated with non-adherence to antiretroviral therapy in adults with AIDS in the first six months of treatment in Salvador, Bahia State, Brazil.

作者信息

Silva José Adriano Góes, Dourado Inês, Brito Ana Maria de, Silva Carlos Alberto Lima da

机构信息

Centro Estadual Especializado em Diagnóstico, Assistência e Pesquisa, Salvador, Brasil.

Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvado, Brasil.

出版信息

Cad Saude Publica. 2015 Jun;31(6):1188-98. doi: 10.1590/0102-311X00106914. Epub 2015 Jun 1.

Abstract

The control of viral replication is essential in the highly active antiretroviral therapy (HAART), and adherence to therapy is instrumental for such control. Individual and external factors influence adhesion to the use of antiretroviral (ARV) drugs. This is a cross-sectional study to investigate factors associated with non-adherence to HAART in AIDS patients in Salvador, Bahia State, Brazil, with age ≥ 13 years and first prescription in 2009. Data was collected from patient charts and pharmacy records. From a total of 216 patients, 65.3% were males; mean age 37.8 ± 9.5 years; single, 67.9%; heterosexual, 64%; more than 8 years of school education, 65.3%; alcohol users, 61.5%; non-smokers, 75,1% or non-illicit drug users, 93.7%. A proportion of 94% started ARV therapy with TCD4+ < 350 cells/mm3; 61.8% were symptomatic; and 68.4% had an adverse drug reaction. The prevalence of non-adherence was 25%. The variables associated were: longer time between HIV infection and AIDS (aOR = 3.9), adverse drug reaction (aOR = 2.4), under 34 years of age (aOR = 2.2), less than 8 years of school education (aOR = 2.2) and illicit drugs use (aOR = 2.6). A high-non-adherence rate is an important problem within the first six months of HAART.

摘要

在高效抗逆转录病毒疗法(HAART)中,控制病毒复制至关重要,而坚持治疗对于这种控制起着关键作用。个体因素和外部因素会影响对抗逆转录病毒(ARV)药物使用的依从性。这是一项横断面研究,旨在调查巴西巴伊亚州萨尔瓦多市年龄≥13岁且于2009年首次开具处方的艾滋病患者中与不坚持HAART相关的因素。数据从患者病历和药房记录中收集。在总共216名患者中,65.3%为男性;平均年龄37.8±9.5岁;单身者占67.9%;异性恋者占64%;接受过8年以上学校教育的占65.3%;饮酒者占61.5%;不吸烟者占75.1%或非非法药物使用者占93.7%。94%的患者在CD4+T细胞<350个/mm³时开始抗逆转录病毒治疗;61.8%有症状;68.4%有药物不良反应。不坚持治疗的患病率为25%。相关变量包括:HIV感染与艾滋病之间的时间间隔较长(调整后比值比[aOR]=3.9)、药物不良反应(aOR=2.4)、34岁以下(aOR=2.2)、接受学校教育不足8年(aOR=2.2)以及使用非法药物(aOR=2.6)。在HAART的前六个月内,高不坚持治疗率是一个重要问题。

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