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埃塞俄比亚西哈拉格地区接受抗逆转录病毒治疗的艾滋病毒感染者体重变化的预测因素:一项回顾性纵向研究

Predictors of Change in Weight Among People Living with HIV on Antiretroviral Treatment in West Hararghe Zone, Ethiopia: A Retrospective Longitudinal Study.

作者信息

Weldesenbet Adisu Birhanu, Ayele Tadesse Awoke, Sisay Malede Mequanent, Tusa Biruk Shalmeno, Kebede Sewnet Adem

机构信息

Department of Epidemiology and Biostatistics, College of Health and Medical Sciences, Haramaya University, Haramaya, Ethiopia.

Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

HIV AIDS (Auckl). 2020 Aug 18;12:373-380. doi: 10.2147/HIV.S262663. eCollection 2020.

Abstract

BACKGROUND

Human immunodeficiency virus (HIV) remains a major global public health issue, particularly in Africa. In resource-limited settings like Ethiopia, regular weight measurement and monitoring is useful in the examination of patient response to antiretroviral therapy and in clinical decision-making. However, there is a paucity of evidence on factors that affect longitudinal weight change. Therefore, the present study was intended to identify predictors of weight change among people living with HIV (PLWH) in West Hararghe, Ethiopia.

METHODS

An institutional-based retrospective cohort study was conducted among 558 PLWH aged 18 years and above from September 2013 to January 2019 at Chiro Zonal Hospital and Gelemso General Hospital in West Hararghe zone, Ethiopia. Data were entered in Epi info 7 and analyzed in R software. The linear mixed effect regression model was used to identify predictors of longitudinal change in weight. Regression coefficients with their 95% confidence intervals were used to indicate the strength and significance of the association.

RESULTS

Weight showed improvement in follow-up periods. In this study, age of respondent (beta=0.136, 95% CI, 0.044:0.227), time since the initiation of antiretroviral therapy (ART) (beta=0.089, 95% CI, 0.075:0.104), primary educational status (beta=2.403, 95% CI, 0.540:4.266), secondary educational status (beta=4.035, 95% CI, 1.666:6.404), tertiary and above educational status (beta=3.444, 95% CI, 0.330:6.558), sex (beta= -5.514, 95% CI, -7.260:-3.768), ambulatory functional status (beta= -3.419, 95% CI, -6.169:-0.668) and baseline CD4 count (≤200) (beta=2.205, 95% CI, 0.593, 3.817) were significant predictors of longitudinal weight change.

CONCLUSION

We observed an increment in weight among PLWH who were on ART in Ethiopia. Educational status, time since the beginning of ART, age and having CD4 count above 200 have contributed positively to the change in weight, while ambulatory functional status and being female are negatively associated with longitudinal change in weight. Close monitoring is recommended for patients with ambulatory baseline functional status and for patients with baseline CD4 count ≤200.

摘要

背景

人类免疫缺陷病毒(HIV)仍然是一个主要的全球公共卫生问题,尤其是在非洲。在像埃塞俄比亚这样资源有限的环境中,定期体重测量和监测对于检查患者对抗逆转录病毒疗法的反应以及临床决策很有用。然而,关于影响体重纵向变化的因素的证据很少。因此,本研究旨在确定埃塞俄比亚西哈拉格地区艾滋病毒感染者(PLWH)体重变化的预测因素。

方法

2013年9月至2019年1月,在埃塞俄比亚西哈拉格地区的奇罗地区医院和盖莱姆索综合医院,对558名18岁及以上的PLWH进行了一项基于机构的回顾性队列研究。数据录入Epi info 7并在R软件中进行分析。使用线性混合效应回归模型来确定体重纵向变化的预测因素。回归系数及其95%置信区间用于表明关联的强度和显著性。

结果

随访期间体重有所改善。在本研究中,受访者年龄(β=0.136,95%CI,0.044:0.227)、开始抗逆转录病毒治疗(ART)后的时间(β=0.089,95%CI,0.075:0.104)、小学教育程度(β=2.403,95%CI,0.540:4.266)、中学教育程度(β=4.035,95%CI,1.666:6.404)、大专及以上教育程度(β=3.444,95%CI,0.330:6.558)、性别(β=-5.514,95%CI,-7.260:-3.768)、非卧床功能状态(β=-3.419,95%CI,-6.169:-0.668)和基线CD4细胞计数(≤200)(β=2.205,95%CI,0.593,3.817)是体重纵向变化的显著预测因素。

结论

我们观察到埃塞俄比亚接受抗逆转录病毒治疗的PLWH体重增加。教育程度、开始抗逆转录病毒治疗后的时间、年龄以及CD4细胞计数高于200对体重变化有积极贡献,而非卧床功能状态和女性与体重纵向变化呈负相关。建议对基线非卧床功能状态的患者和基线CD4细胞计数≤200的患者进行密切监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e2a6/7445526/e593deede690/HIV-12-373-g0001.jpg

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