戈亚斯州某城市艾滋病病毒/艾滋病感染者的抗逆转录病毒治疗依从性及其与不良反应和合并感染的相关性
Adherence to antiretroviral therapy and correlation with adverse effects and coinfections in people living with HIV/AIDS in the municipality of Goiás State.
作者信息
Oliveira Luane da Silva, Caixeta Lorena Maria, Martins José Luís Rodrigues, Segati Kelly Deyse, Moura Rodrigo Scaliante, Daher Marcelo Cecílio, Pinto Emerith Mayra Hungria
机构信息
Centro Universitário de Anápolis, UniEVANGÉLICA, Anápolis, GO, Brasil.
出版信息
Rev Soc Bras Med Trop. 2018 Jul-Aug;51(4):436-444. doi: 10.1590/0037-8682-0467-2017.
INTRODUCTION
Acquired immunodeficiency syndrome is an advanced stage of a human immunodeficiency virus infection. The antiretroviral therapy aims to improve the life quality of HIV patients and a good adherence is essential for a better prognosis. This study aimed to evaluate the adherence of human immunodeficiency virus/acquired immunodeficiency syndrome patients to antiretroviral therapy recommended by the Brazilian health system in Anápolis/Goiás, and correlate the level of adherence with sociodemographic data and clinical-laboratory variables.
METHODS
Adherence to antiretroviral therapy was assessed using the Questionnaire for Evaluation of Adherence to Antiretroviral Therapy. The sociodemographic data were collected using a standardized questionnaire and the clinical-laboratory records were reviewed.
RESULTS
Among 220 patients included, 59% (129/220) were men and the average age was 41 years. Infection was acquired primarily through sexual contact (92%, 202/220), and 69% (152/220) of the patients were heterosexual. Approximately 86% (188/220) of the patients had good or strict adherence to antiretroviral therapy. In our study, the use of illicit drugs was associated with low adherence to antiretroviral therapy (p=0.0004), and no significant association was observed between adherence levels and other sociodemographic data (p>0.05). The logistic regression indicated that adverse effects (p=0.0018) and sexual orientation (p=0.0152) were associated with the level of adherence to antiretroviral therapy. Patients with good or strict adherence had higher CD4+T lymphocyte count (p<0.0001) and undetectable viral load (p<0.0001). Patients with low adherence (14%, 32/220) had higher frequency of adverse events (p=0.0009). The frequency of coinfections was 25% (55/220), with syphilis and tuberculosis being the most common coinfections.
CONCLUSIONS
Adherence was related to use of illicit drugs, adverse effects, and sexual orientation.
引言
获得性免疫缺陷综合征是人类免疫缺陷病毒感染的晚期阶段。抗逆转录病毒疗法旨在提高艾滋病患者的生活质量，良好的依从性对于改善预后至关重要。本研究旨在评估戈亚斯州阿纳波利斯市人类免疫缺陷病毒/获得性免疫缺陷综合征患者对巴西卫生系统推荐的抗逆转录病毒疗法的依从性，并将依从水平与社会人口学数据及临床实验室变量进行关联分析。
方法
使用抗逆转录病毒疗法依从性评估问卷来评估对抗逆转录病毒疗法的依从性。通过标准化问卷收集社会人口学数据，并查阅临床实验室记录。
结果
在纳入的220名患者中，59%（129/220）为男性，平均年龄为41岁。感染主要通过性接触获得（92%，202/220），69%（152/220）的患者为异性恋。约86%（188/220）的患者对抗逆转录病毒疗法有良好或严格的依从性。在我们的研究中，使用非法药物与对抗逆转录病毒疗法的低依从性相关（p = 0.0004），且未观察到依从水平与其他社会人口学数据之间存在显著关联（p>0.05）。逻辑回归表明，不良反应（p = 0.0018）和性取向（p = 0.0152）与抗逆转录病毒疗法的依从水平相关。依从性良好或严格的患者CD4 + T淋巴细胞计数较高（p<0.0001）且病毒载量不可检测（p<0.0001）。依从性低的患者（14%，32/220）不良事件发生率较高（p = 0.0009）。合并感染的发生率为25%（55/220），梅毒和结核病是最常见的合并感染。
结论
依从性与非法药物使用、不良反应和性取向有关。
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