Negash Hadush, Welay Miglas, Legese Haftom, Adhanom Gebre, Mardu Fitsum, Tesfay Kebede, Gebrewahd Aderajew, Berhe Brhane
Unit of Medical Microbiology, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Adigrat University, Tigrai, Ethiopia.
Department of Midwifery, College of Medicine and Health Sciences, Adigrat University, Tigrai, Ethiopia.
Infect Drug Resist. 2020 Jun 18;13:1863-1872. doi: 10.2147/IDR.S251619. eCollection 2020.
In Ethiopia, despite the integrated implementation of antiretroviral therapy since 2005, the human immunodeficiency virus remains a public health concern. Managing and detecting antiretroviral treatment response is important to monitor the effectiveness of the therapy for individuals who experience failed virological response. An increased viral load indicating drug resistance or rapid progression of viral replication needs early detection. Hence, we aimed to assess the prevalence and determinants of virological response among human immunodeficiency virus-infected patients on highly active antiretroviral therapy.
A hospital-based cross-sectional study was conducted in Adigrat General Hospital from September to December, 2019, on a total of 422 participants. An interviewer-based questionnaire was used for data collection. About 4 mL of venous blood was collected for viral load determination. Patient records were reviewed for the previous results of CD4+ T cell counts. STATA 14 software was used to analyze the data. Descriptive data were presented using tables and figures. Bivariate and multivariate analyses were performed. A p-value < 0.05 was considered a statistically significant association.
The mean age of study participants was 39 years (SD ±12.2 years), of which 66.7% of them were females. The overall prevalence of virological failure was 12.47% (49/393). Moreover, the prevalence of virological failure was observed to be higher among tuberculosis co-infected individuals (26%) compared with the mono-infected HIV patients (6.3%). The odds of virological failure were higher among obese and undernourished individuals, tuberculosis co-infected, and individuals with the failure of immune reconstitution.
There was a high rate of virological failure among the study participants. Tuberculosis infection increased the rate of failure. There should be consistent assessment of viral load testing to determine the status of virological response for appropriate drug switching to clients. HIV patients with virological failure are recommended for switching of the antiretroviral therapy.
在埃塞俄比亚，尽管自2005年以来已综合实施抗逆转录病毒疗法，但人类免疫缺陷病毒仍然是一个公共卫生问题。管理和检测抗逆转录病毒治疗反应对于监测病毒学反应失败的个体的治疗效果很重要。病毒载量增加表明耐药性或病毒复制快速进展需要早期检测。因此，我们旨在评估接受高效抗逆转录病毒治疗的人类免疫缺陷病毒感染患者中病毒学反应的患病率和决定因素。
2019年9月至12月在阿迪格拉特综合医院进行了一项基于医院的横断面研究，共有422名参与者。使用基于访谈的问卷进行数据收集。采集约4毫升静脉血用于病毒载量测定。查阅患者记录以获取先前的CD4+T细胞计数结果。使用STATA 14软件分析数据。描述性数据用表格和图表呈现。进行了双变量和多变量分析。p值<0.05被认为具有统计学显著关联。
研究参与者的平均年龄为39岁（标准差±12.2岁），其中66.7%为女性。病毒学失败的总体患病率为12.47%（49/393）。此外，观察到与单纯感染艾滋病毒的患者（6.3%）相比，合并结核病感染的个体中病毒学失败的患病率更高（26%）。肥胖和营养不良个体、合并结核病感染以及免疫重建失败的个体中病毒学失败的几率更高。
研究参与者中病毒学失败率很高。结核病感染增加了失败率。应持续评估病毒载量检测，以确定病毒学反应状态，以便为患者适当更换药物。建议病毒学失败的艾滋病毒患者更换抗逆转录病毒疗法。
