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抗逆转录病毒疗法开始后生活在埃塞俄比亚西北部的艾滋病毒感染者体重变化:一项纵向数据分析。

Weight change after antiretroviral therapy initiation among adults living with HIV in Northwest Ethiopia: a longitudinal data analysis.

机构信息

College of Health Science, Debre Markos University, Debre Markos, Ethiopia

School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.

出版信息

BMJ Open. 2022 Feb 1;12(2):e055266. doi: 10.1136/bmjopen-2021-055266.

Abstract

OBJECTIVES

The first objective was to explore weight change in the first 2 years after antiretroviral therapy (ART) initiation in adults living with HIV. The second objective was to identify the predictors of weight change over time among adults living with HIV on ART.

DESIGN

An institution-based retrospective longitudinal study was conducted.

SETTING

The study was conducted at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia.

PARTICIPANTS

The study included 848 randomly selected medical charts of adults living with HIV receiving ART between June 2014 and June 2020.

PRIMARY AND SECONDARY OUTCOMES

The primary outcome was weight change in the first 2 years after ART initiation. The secondary outcome was to identify predictors of weight change. Association between predictor variables and weight change was assessed using an LMM. Variables with p values <0.05 in the final model were considered as statistically significant predictors of weight change.

RESULTS

Of 844 study participants, more than half (n=499; 58.8%) were female. Participants' mean weight increased from 54.2 kg (SD ±9.6 kg) at baseline to 59.5 kg (SD ±10.7 kg) at the end of follow-up. Duration of time on ART, sex, WHO clinical disease staging, functional status, nutritional status and presence of opportunistic infections were significant predictors of weight change at ART initiation. Significant interaction effects were observed between time and sex, WHO clinical disease staging, functional status, isoniazid preventive therapy and nutritional status.

CONCLUSION

We found a linear increment of weight over 24 months of follow-up. Rate of weight gain over time was lower in patients with advanced disease stage and working functional status, whereas weight gain rate was higher in male and underweight patients.

摘要

目的

第一项目的是探索接受抗逆转录病毒疗法(ART)治疗的成年人在开始治疗后的头 2 年内体重的变化情况。第二项目的是确定在接受 ART 治疗的 HIV 感染者中,随时间推移体重变化的预测因素。

设计

一项基于机构的回顾性纵向研究。

地点

研究在埃塞俄比亚西北部德布雷马科斯综合专科医院进行。

参与者

本研究纳入了 2014 年 6 月至 2020 年 6 月期间接受 ART 治疗的 848 名随机选择的 HIV 感染者的病历。

主要和次要结局

主要结局是在开始 ART 治疗后的头 2 年内体重的变化。次要结局是确定体重变化的预测因素。采用 LMM 评估预测变量与体重变化之间的关联。在最终模型中 p 值<0.05 的变量被认为是体重变化的统计学显著预测因素。

结果

在 844 名研究参与者中,超过一半(n=499;58.8%)为女性。参与者的平均体重从基线时的 54.2kg(SD±9.6kg)增加到随访结束时的 59.5kg(SD±10.7kg)。ART 开始时,ART 持续时间、性别、世界卫生组织临床疾病分期、功能状态、营养状况和机会性感染的存在是体重变化的显著预测因素。观察到时间与性别、世界卫生组织临床疾病分期、功能状态、异烟肼预防治疗和营养状况之间存在显著的交互效应。

结论

我们发现随访 24 个月时体重呈线性增加。在疾病晚期和有工作功能状态的患者中,体重随时间的增长速度较慢,而在男性和体重不足的患者中,体重增长速度较快。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2dd5/8808440/8ffb657fb020/bmjopen-2021-055266f01.jpg

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