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在肯尼亚一家转诊医院中,齐多夫定和替诺福韦治疗方案对HIV患者健康相关生活质量及症状发生率的比较

Comparison of Zidovudine and Tenofovir Based Regimens With Regard to Health-Related Quality of Life and Prevalence of Symptoms in HIV Patients in a Kenyan Referral Hospital.

作者信息

Etenyi Jilian O, Okalebo Faith A, Oluka Margaret, Sinei Kipruto A, Osanjo George O, Kurdi Amanj, Meyer Johanna C, Godman Brian, Opanga Sylvia

机构信息

Department of Pharmacology and Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya.

Department of Pharmaceutics and Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya.

出版信息

Front Pharmacol. 2018 Oct 12;9:984. doi: 10.3389/fphar.2018.00984. eCollection 2018.

Abstract

Zidovudine and tenofovir form the backbone of antiretroviral therapy in Kenya. However, their side-effects may affect the quality of life (QoL) of patients. The aim was to compare the health-related quality of life (HRQoL) of adult patients on tenofovir versus zidovudine based regimens in a referral hospital in Kenya to provide future guidance. A comparative cross sectional study among 501 adult out-patients on either tenofovir or zidovudine was undertaken in Kenyatta National Hospital between 2015 and 2016. The Medical Outcome Study HIV Health Survey (MOS-HIV) was administered along with other key aspects of treatment. Linear regression analysis was performed to identify determinants of HRQoL. Patients on zidovudine had a higher Physical Health Summary Score (PHSS) and Mental Health Summary Score (MHSS) compared to those on tenofovir. The presence of any symptom of the disease and a stated inability to cope were negatively associated with PHSS, whilst having a regular source of income improved PHSS. Being on tenofovir, symptom of illness [β = -1.24; 95% CI (-2.253, -0.226)], absence of pain [β=0.413; 95% CI (0.152, 0.674)] and patient stated inability to cope with HIV [β = -1.029; 95% CI (-1.441, -0.617)] affected the MHSS. Patients on tenofovir and second line regimens had more signs and symptoms of illness. Participants on zidovudine based regimens showed a better performance across all aspects of HRQoL. These are considerations for the future.

摘要

齐多夫定和替诺福韦是肯尼亚抗逆转录病毒疗法的基础用药。然而,它们的副作用可能会影响患者的生活质量(QoL)。本研究旨在比较肯尼亚一家转诊医院中接受基于替诺福韦与齐多夫定治疗方案的成年患者的健康相关生活质量(HRQoL),以便为未来提供指导。2015年至2016年期间,在肯雅塔国家医院对501名使用替诺福韦或齐多夫定的成年门诊患者进行了一项比较横断面研究。除治疗的其他关键方面外,还实施了医学结果研究艾滋病毒健康调查(MOS-HIV)。进行线性回归分析以确定HRQoL的决定因素。与使用替诺福韦的患者相比,使用齐多夫定的患者有更高的身体健康总结评分(PHSS)和心理健康总结评分(MHSS)。疾病的任何症状以及自述无法应对与PHSS呈负相关,而有固定收入来源则可改善PHSS。使用替诺福韦、疾病症状[β = -1.24;95%置信区间(-2.253,-0.226)]、无疼痛[β = 0.413;95%置信区间(0.152,0.674)]以及患者自述无法应对艾滋病毒[β = -1.029;95%置信区间(-1.441,-0.617)]影响了MHSS。使用替诺福韦和二线治疗方案的患者有更多疾病体征和症状。接受基于齐多夫定治疗方案的参与者在HRQoL的各个方面表现更好。这些是未来需要考虑的因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f5e/6194154/ca4b17fd35e1/fphar-09-00984-g001.jpg

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