Muzaliwa Ildefonse, Isia Nancy Francisca, Yenga Dady, Kikobya Denis, Lunjwire Prince, Katchunga Philippe Bianga
Regional School of Public Health / Faculty of Medicine of the Catholic University of Bukavu, Po Box 285, Bukavu, Democratic Republic of Congo.
Department of Internal Medicine, Faculty of Medicine of the Catholic University of Bukavu, PoBox 285, Bukavu, Democratic Republic of Congo.
Pan Afr Med J. 2016 Dec 6;25:210. doi: 10.11604/pamj.2016.25.210.9799. eCollection 2016.
The late screening of the majority of patients in sub Saharan region would justify a systematic antiretroviral treatment without breaking the country programs vision. he objective of this study was to determine the validity of biological eligibility criteria to antiretroviral treatment compared with systematic antiretroviral treatment in a cohort of the people living with HIV in Bukavu city.
One thousand hundred and forty-nine (1149) records of people living with HIV (PLWIV) followed in three HIV health care facilities of Bukavu city were selected systematically. The ROC curve was constructed and analyzed to assess the validity of systematic antiretroviral therapy and a treatment based on WHO biological criteria.
The CD4 median count was 196 /mm. On admission, only 17.3% of PLWHIV had a CD4≥500/mm. Compared to the criteria "systematic antiretroviral treatment", biological eligibility criteria for antiretroviral therapy, had a sensitivity of 94.9%, a specificity of 100%, an AUC of 0.97 (0.96 to 0.98) (p <0.0001) and correlation coefficient of 0.88.
This study shows that a systematic antiretroviral treatment of seropositive patients newly detected for the HIV in sub-Saharan Africa area must be requirement outwards WHO current recommendations. Also, in order to optimize expected outcome of a systematic treatment, a systematic screening in the high-risk groups of this area should be recommended.
撒哈拉以南地区大多数患者的晚期筛查表明,在不违背国家项目愿景的情况下,进行系统性抗逆转录病毒治疗是合理的。本研究的目的是在布卡武市的一组艾滋病毒感染者中,确定抗逆转录病毒治疗的生物学资格标准与系统性抗逆转录病毒治疗相比的有效性。
系统选取了在布卡武市三个艾滋病毒医疗设施接受随访的1149名艾滋病毒感染者(PLWIV)的记录。构建并分析ROC曲线,以评估系统性抗逆转录病毒疗法和基于世界卫生组织生物学标准的治疗的有效性。
CD4细胞计数中位数为196/mm³。入院时,只有17.3%的艾滋病毒感染者CD4≥500/mm³。与“系统性抗逆转录病毒治疗”标准相比,抗逆转录病毒治疗的生物学资格标准的敏感性为94.9%,特异性为100%,AUC为0.97(0.96至0.98)(p<0.0001),相关系数为0.88。
本研究表明,在撒哈拉以南非洲地区,对新检测出的血清阳性艾滋病毒患者进行系统性抗逆转录病毒治疗必须超出世界卫生组织目前的建议。此外,为了优化系统性治疗的预期结果,建议对该地区的高危人群进行系统性筛查。