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埃塞俄比亚中南部绍阿西南地区成人 HIV 阳性患者一线基于病毒学的抗逆转录病毒治疗失败及相关因素

First-line virologic-based ART treatment failure and associated factors among adult HIV Positives in Southwest Shoa, Central Ethiopia.

机构信息

School of Nursing and Midwifery, Institutes of Health Sciences, 128159Wollega University, Nekemte, Ethiopia.

Department of Public Health, Institutes of Health Sciences, 128159Wollega University, Nekemte, Ethiopia.

出版信息

J Int Assoc Provid AIDS Care. 2022 Jan-Dec;21:23259582221111080. doi: 10.1177/23259582221111080.

Abstract

The function of antiretroviral therapy is to enhance immunity and prevent the occurrence of opportunistic infection. But antiretroviral therapy showed a failure to manage infection after a time. Nowadays, an accepted criterion to confirm Antiretroviral therapy (ART) treatment failure is a virologic failure. Regarding this virologic failure, there are no well-addressed findings, especially in this study area. Therefore in this research, the magnitude and factors that contribute for virological ART treatment failure have been identified. Facilitybased cross-sectional study was conducted on adult patients taking ART. Data entry was conducted using Epi Data Version3 and exported to Stata SE version 14 for analysis. Bivariable logistic regression was used to find covariates significantly associated with firs line ART treatment failure. In this case, variables with -value ≤ .25 were a candidate for multiple logistic regressions. A backward logistic regression model was used. Finally, variables with -value ≤ .05 were considered as factors significantly associated with first-line ART treatment failure and the result was presented with a description, graph, and tables. In this study, three hundred and fifty peoples were a candidate for the study and all have been involved. The magnitude of first-line ART treatment failure based on virologic criteria was 20.85%. Greater than three-fourth (84.29%) of study participants have support from somebody. Those patients who have initiated first-line ART with NVP based regimen have 1.83 times more likely to face first-line ART treatment failure as compared with those who have started with Efeverence (EFV) based regimen [AOR = 1.83, 95% CI (1.035, 3.245)]. Patients who have initiated first-line ART at the health center were 3.093 times more likely to face first-line ART treatment failure as compared those who have initiated ART at hospitals [AOR = 3.093, 95% CI (1.101, 8.685)]. Patients who have not developed a common opportunistic infection after ART initiation was 47.3% less likely to encounter first-line ART treatment failure as compared with those who have opportunistic infection [AOR = 0.527, 95% CI (0.289, 0.961)]. Based on virologic criteria, NVP based ART initiation, having history recorded opportunistic infection after ART initiation, being male, Institution where initiate ART, are significantly associated with the occurrences of first-line ART treatment failure. The action has to be directed on those identified factors to maintain the patient stay on First-line ART by concerned stakeholders.

摘要

抗逆转录病毒疗法的功能是增强免疫力并预防机会性感染的发生。但一段时间后,抗逆转录病毒疗法显示出对感染的控制失败。如今,公认的确认抗逆转录病毒治疗(ART)治疗失败的标准是病毒学失败。关于这种病毒学失败,没有很好的解决方法,尤其是在这个研究领域。因此,在这项研究中,确定了导致病毒学 ART 治疗失败的程度和因素。

我们对接受 ART 治疗的成年患者进行了基于机构的横断面研究。数据输入使用 Epi Data 版本 3 进行,并导出到 Stata SE 版本 14 进行分析。使用双变量逻辑回归来确定与一线 ART 治疗失败显著相关的协变量。在这种情况下,P 值≤0.25 的变量是多变量逻辑回归的候选变量。使用向后逻辑回归模型。最后,P 值≤0.05 的变量被认为与一线 ART 治疗失败显著相关,并以描述、图表和表格的形式呈现结果。

在这项研究中,有 350 人是研究的候选人,并且都已参与。根据病毒学标准,一线 ART 治疗失败的程度为 20.85%。超过四分之三(84.29%)的研究参与者得到了某人的支持。与那些开始使用依非韦伦(EFV)为基础方案的患者相比,开始使用奈韦拉平(NVP)为基础方案的患者面临一线 ART 治疗失败的可能性高 1.83 倍[比值比(AOR)=1.83,95%置信区间(CI)(1.035,3.245)]。在卫生中心开始一线 ART 的患者与在医院开始 ART 的患者相比,发生一线 ART 治疗失败的可能性高 3.093 倍[AOR=3.093,95%CI(1.101,8.685)]。与发生机会性感染的患者相比,ART 启动后未发生常见机会性感染的患者发生一线 ART 治疗失败的可能性低 47.3%[AOR=0.527,95%CI(0.289,0.961)]。

基于病毒学标准,NVP 为基础的 ART 启动、ART 启动后有记录的机会性感染史、男性、开始 ART 的机构,均与一线 ART 治疗失败的发生显著相关。必须针对这些已确定的因素采取行动,以维持利益相关者对患者继续接受一线 ART 的关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c57/9297459/baf24d25252e/10.1177_23259582221111080-fig1.jpg

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