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南非特洛奎诊所接受抗逆转录病毒疗法的老年人的特征与治疗结果

Characteristics and outcomes of older people on antiretroviral therapy in Tlokwe Clinics, South Africa.

作者信息

Rabe Mareike, Lion-Cachet Huibrecht C, Eyassu Melaku A

机构信息

Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

South Afr J HIV Med. 2020 Jul 7;21(1):1066. doi: 10.4102/sajhivmed.v21i1.1066. eCollection 2020.

Abstract

BACKGROUND

South Africa (SA) has a large human immunodeficiency virus (HIV) epidemic but little is known of its effect on those ≥ 60 years of age viz. 'older-persons' living with HIV (OPLWH). Numbers in this age group are increasing and are expected to place a greater strain on existing resources.

OBJECTIVES

To describe the demographic features and the co-morbidities of OPLWH in Tlokwe. This included an assessment of viral load (VL) suppression and the identification of associations between patient characteristics and clinical outcomes.

METHODS

A retrospective file review was undertaken to cover the period 01 May 2017 to 30 April 2018. Descriptive statistics were applied to demographic and clinical data and to treatment outcomes. Statistically significant associations were subjected to logistic regression analysis.

RESULTS

Of the 191 participants, 111/191 (58.1%) were female and 167/191 (87.4%) were 60 -70 years of age. Of the participants, 154/191 (81.9%) were virally suppressed (< 400 copies/mL). Hypertension ( = 106/191, 55.5%) was the most frequently identified co-morbidity. A CD4 cell count of ≥ 350 cells/mm at last assessment correlated positively with VL suppression (odds ratio 2.3, confidence interval 1.05-5.02, = 0.037).

CONCLUSION

Although the level of VL suppression in this cohort was high, greater effort is required to bring this in line with the Joint United Nations Programme on HIV/AIDS (UNAIDS) recommendations viz. 90% viral suppression in PLWH by 2030. Further research is needed to define the evolving long-term needs of OPLWH and to facilitate entry into care of those currently not in care.

摘要

背景

南非存在大规模的人类免疫缺陷病毒(HIV)疫情,但对于其对60岁及以上人群(即感染HIV的老年人,OPLWH)的影响知之甚少。这个年龄组的人数正在增加,预计将给现有资源带来更大压力。

目的

描述特洛奎地区OPLWH的人口统计学特征和合并症。这包括评估病毒载量(VL)抑制情况以及确定患者特征与临床结局之间的关联。

方法

进行了一项回顾性档案审查,涵盖2017年5月1日至2018年4月30日期间。对人口统计学和临床数据以及治疗结果应用描述性统计。对具有统计学意义的关联进行逻辑回归分析。

结果

在191名参与者中,111/191(58.1%)为女性,167/191(87.4%)年龄在60 - 70岁之间。在参与者中,154/191(81.9%)的病毒得到抑制(<400拷贝/毫升)。高血压(106/191,55.5%)是最常发现的合并症。最后一次评估时CD4细胞计数≥350个细胞/立方毫米与VL抑制呈正相关(优势比2.3,置信区间1.05 - 5.02,P = 0.037)。

结论

尽管该队列中的VL抑制水平较高,但仍需要做出更大努力,使其符合联合国艾滋病规划署(UNAIDS)的建议,即到2030年使90%的PLWH实现病毒抑制。需要进一步研究来确定OPLWH不断变化的长期需求,并促进目前未接受治疗的患者获得治疗。

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