Wakooko Paul, Gavamukulya Yahaya, Wandabwa Julius N
Department of Community and Public Health, Faculty of Health Sciences, Busitema University, Mbale, Uganda.
Sironko District Local Government, Eastern Uganda.
Infect Dis (Auckl). 2020 Nov 5;13:1178633720970632. doi: 10.1177/1178633720970632. eCollection 2020.
BACKGROUND: HIV viral load suppression (VLS) is the most important indicator of successful antiretroviral therapy. In 2016, Bulambuli District started monitoring HIV patients on ART using viral load tests in an effort to meet the third 90 of the UNAIDS 90-90-90 strategy which is VLS. The objective of this study was to determine the progress in Bulambuli District towards achievement of VLS among HIV infected patients on ART and associated factors that affect this programme. METHODS: A retrospective cohort study design was used. One thousand, one hundred and one medical records of HIV infected patients on ART who attended HIV clinic at Muyembe Health Centre IV from June 2016 to April 2018 were reviewed. A data abstraction tool was used for data collection. Chi Square was used to determine factors associated with VLS and logistic regression was used to determine the magnitude by which the ART and clinical factors influence VLS. Data were summarized using descriptive statistics for categorical variables and by computing proportions, means and standard deviation for continuous variables. RESULTS: Of the patients (n = 944, 85.7%) had attained VLS. Adjusting for known confounders, only adherence to ART was a significant predictor of VLS. Individuals with fair adherence (80%-95%) had 2.667 times the odds of VLS, CI = 1.122-9.370, -value of <.002 compared to individuals with good (>95%) adherence which was used as the reference while those with poor (<80%) adherence had 4.553 times the odds of attaining VLS, CI = 1.31-13.930, -value of <.001 compared to individuals with good adherence. CONCLUSION: These findings suggest that Bulambuli District, at 85.7% VLS is on track to attaining the third 90 of the 90, 90, 90 global targets by 2020. It further reveals that adherence is the only significant predictor of VLS in the District.
背景:HIV病毒载量抑制(VLS)是抗逆转录病毒治疗成功的最重要指标。2016年,布兰布利区开始使用病毒载量检测对接受抗逆转录病毒治疗的HIV患者进行监测,以努力实现联合国艾滋病规划署90-90-90战略的第三个90目标,即病毒载量抑制。本研究的目的是确定布兰布利区在接受抗逆转录病毒治疗的HIV感染患者中实现病毒载量抑制方面的进展以及影响该计划的相关因素。 方法:采用回顾性队列研究设计。对2016年6月至2018年4月在穆延贝四级健康中心HIV诊所接受抗逆转录病毒治疗的1101例HIV感染患者的病历进行了回顾。使用数据提取工具进行数据收集。卡方检验用于确定与病毒载量抑制相关的因素,逻辑回归用于确定抗逆转录病毒治疗和临床因素对病毒载量抑制的影响程度。使用分类变量的描述性统计以及计算连续变量的比例、均值和标准差对数据进行总结。 结果:在这些患者中,944例(85.7%)实现了病毒载量抑制。在对已知混杂因素进行调整后,只有对抗逆转录病毒治疗的依从性是病毒载量抑制的显著预测因素。依从性一般(80%-95%)的个体实现病毒载量抑制的几率是依从性良好(>95%)个体的2.667倍,置信区间为1.122-9.370,P值<0.002,依从性良好的个体作为参照;而依从性差(<80%)的个体实现病毒载量抑制的几率是依从性良好个体的4.553倍,置信区间为1.31-13.930,P值<0.001。 结论:这些发现表明,布兰布利区的病毒载量抑制率为85.7%,有望在2020年实现9,0,90全球目标的第三个90。这进一步表明,依从性是该地区病毒载量抑制的唯一重要预测因素。
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