Institute for Preventive Medicine and Public Health, Hanoi Medical University, 1 Ton That Tung, Kim Lien, Dong Da, Hanoi, Vietnam.
Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
AIDS Behav. 2019 Oct;23(10):2840-2848. doi: 10.1007/s10461-019-02571-z.
A mixed design approach was performed to assess the CD4 count levels over time and their associated factors among 362 HIV patients on ART from clinics with HIV testing and counseling (ART-HTC) services and those with general healthcare (ART-GH) services. Longitudinal CD4 count data were retrospectively collected from medical records. Sociodemographic, clinical, alcohol use and smoking characteristics were obtained via face-to-face interviews. Multivariate mixed effect linear regression was utilized to determine the association. We found that HIV patients at ART-GH clinics were more likely to achieve higher CD4 counts over time compared to patients at ART-HTC clinics. Additionally, having an increase in CD4 counts was found to be associated with having longer duration of ART and higher baseline CD4 levels. Cigarette smoking and hazardous alcohol use, however, were not associated with CD4 count improvement. Our findings suggest that combining HTC and GH services might provide a synergistic benefit in ART treatment outcomes through an improved access to comprehensive HIV healthcare services for HIV patients on therapy.
采用混合设计方法评估了 362 名接受抗逆转录病毒治疗（ART）的艾滋病毒患者的 CD4 计数水平随时间的变化及其相关因素，这些患者分别来自提供艾滋病毒检测和咨询（ART-HTC）服务的诊所和提供一般医疗保健（ART-GH）服务的诊所。纵向 CD4 计数数据是从病历中回顾性收集的。通过面对面访谈获得社会人口统计学、临床、酒精使用和吸烟特征。采用多变量混合效应线性回归来确定相关性。我们发现，与 ART-HTC 诊所的患者相比，ART-GH 诊所的 HIV 患者随着时间的推移更有可能实现更高的 CD4 计数。此外，CD4 计数的增加与接受抗逆转录病毒治疗的时间延长和基线 CD4 水平升高有关。然而，吸烟和危险饮酒与 CD4 计数的改善无关。我们的研究结果表明，将 HTC 和 GH 服务相结合，通过为接受治疗的 HIV 患者提供更好的综合艾滋病毒保健服务，可能会在抗逆转录病毒治疗结果方面产生协同效益。
