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缅甸艾滋病治疗期间的间歇预防治疗:高覆盖率、完成率及药物依从性

IPT during HIV treatment in Myanmar: high rates of coverage, completion and drug adherence.

作者信息

Ousley J, Soe K P, Kyaw N T T, Anicete R, Mon P E, Lwin H, Win T, Cristofani S, Telnov A, Fernandez M, Ciglenecki I

机构信息

Médecins Sans Frontières, Geneva, Switzerland.

National Tuberculosis Programme, Department of Health, Ministry of Health, Yangon, Myanmar.

出版信息

Public Health Action. 2018 Mar 21;8(1):20-24. doi: 10.5588/pha.17.0087.

Abstract

A southern Myanmar district providing isoniazid preventive therapy (IPT) in one of the last countries to formally recommend it as part of human immunodeficiency virus (HIV) care. To assess coverage and adherence and the feasibility of IPT scale-up in a routine care setting in Myanmar. A retrospective analysis of people living with HIV (PLHIV) screened for tuberculosis (TB) and enrolled in IPT over a 3-year period (July 2011-June 2014) using clinical databases. Among 3377 patients under HIV care and screened for TB, 2740 (81.1%) initiated IPT, with 2651 (96.8%) completing a 6- or 9-month course of IPT; 83 (3.1%) interrupted treatment for different reasons, including loss to follow-up ( = 41), side effects ( = 15) or drug adherence issues ( = 9); 6 (0.2%) died. Among the IPT patients, 33 (1.2%) were diagnosed with TB, including 9 (0.3%) while on IPT and 24 (0.9%) within 1 year of completion of therapy. Among the PLHIV who completed IPT, one case of isoniazid resistance was detected. Scaling up IPT in Myanmar HIV settings is feasible with high rates of drug adherence and completion, and a low rate of discontinuation due to side effects. IPT scale-up should be prioritised in HIV clinical settings in Myanmar.

摘要

缅甸南部的一个地区提供异烟肼预防性治疗(IPT),该国是最后一批正式推荐将其作为人类免疫缺陷病毒(HIV)护理一部分的国家之一。旨在评估缅甸常规护理环境中IPT的覆盖范围、依从性以及扩大规模的可行性。使用临床数据库对在3年期间(2011年7月至2014年6月)接受结核病(TB)筛查并登记接受IPT的HIV感染者(PLHIV)进行回顾性分析。在3377名接受HIV护理并接受TB筛查的患者中,2740人(81.1%)开始接受IPT,其中2651人(96.8%)完成了6个月或9个月的IPT疗程;83人(3.1%)因不同原因中断治疗,包括失访(=41)、副作用(=15)或药物依从性问题(=9);6人(0.2%)死亡。在接受IPT的患者中,33人(1.2%)被诊断患有TB,其中9人(0.3%)在接受IPT期间发病,24人(0.9%)在治疗完成后1年内发病。在完成IPT的PLHIV中,检测到1例异烟肼耐药病例。在缅甸的HIV环境中扩大IPT规模是可行的,药物依从性和完成率很高,因副作用导致的停药率很低。在缅甸的HIV临床环境中应优先扩大IPT规模。

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