Department of Public Health, College of Health Sciences, Salale University, Fitche, Ethiopia.
Department of Public Health, College of health sciences, Dire Dawa University, Dire Dawa, Ethiopia.
Medicine (Baltimore). 2022 Jul 22;101(29):e29905. doi: 10.1097/MD.0000000000029905.
Opportunistic infections (OIs) in HIV patients are infections that are more common or more severe as a result of HIV-mediated immunosuppression. The advances in the capacity of antiretroviral therapy (ART) have diminished the incidence of OIs. However, even in the ART era, HIV-related OIs continue to be major causes of hospitalization and mortality. Therefore, this study aims to identify time to occurrence, predictors, and patterns of OIs incidence among HIV-positive patients attending ART clinic of Salale University Comprehensive Specialized Hospital, Ethiopia. A retrospective cohort study was conducted between 1st September 2016 and 1st September 2021. All 419 patients diagnosed during the study period were recruited. Data were extracted from both patient medical records and ART logbooks. Stata-16 was used for data analysis. Follow-up time was calculated from the date of HIV diagnosis to the date of OIs occurrence or censoring. Cox proportional hazards regression model was used to identify the predictors of OIs incidence. The total person-time of the follow-up was 8656 person-months of observation. During the follow-up time, 199 (47.49%) of the patients had developed OIs. The incidence rate of OIs was 23 (95%CI: 20, 26) per 1000 person-months of observation. The median OIs free survival time was 36 (95%CI: 31, 40) months. Predictors such as residence, cd4 category, baseline hemoglobin level, ART side effects, isoniazid preventive therapy, and chronic disease comorbidity were significantly predicted OIs incidence. The study area's OIs incidence remained high, requiring prompt action. To reduce the morbidity and mortality associated with OIs, HIV-positive patients with the predictors of rural residence, low CD4 category, low baseline hemoglobin level, ART side effects, not taking IPT, and baseline chronic disease comorbidity necessitate close follow-up and monitoring. Thus, we recommend focused and evidence-informed strategies to address OIs burden and improve outcomes.
艾滋病毒患者的机会性感染（OIs）是指由于 HIV 介导的免疫抑制而更常见或更严重的感染。抗逆转录病毒疗法（ART）能力的提高降低了 OIs 的发生率。然而，即使在 ART 时代，HIV 相关的 OIs 仍然是住院和死亡的主要原因。因此，本研究旨在确定时间发生、预测因素和艾滋病毒阳性患者机会性感染发生率的模式，这些患者在埃塞俄比亚 Salale 大学综合专科医院的 ART 诊所就诊。这是一项回顾性队列研究，于 2016 年 9 月 1 日至 2021 年 9 月 1 日进行。所有在研究期间确诊的 419 名患者均被纳入研究。数据从患者病历和 ART 日志中提取。Stata-16 用于数据分析。随访时间从 HIV 诊断日期计算到 OIs 发生或删失日期。Cox 比例风险回归模型用于识别 OIs 发生率的预测因素。随访期间总随访时间为 8656 人月。在随访期间，199 名（47.49%）患者发生了 OIs。OIs 的发生率为 23（95%CI：20，26）/1000 人月。OIs 无事件生存时间的中位数为 36（95%CI：31，40）个月。居住地、CD4 分类、基线血红蛋白水平、ART 副作用、异烟肼预防治疗和慢性病合并症等预测因素均显著预测 OIs 发生率。研究区域的 OIs 发病率仍然很高，需要采取紧急行动。为了降低与 OIs 相关的发病率和死亡率，需要对具有农村居住地、低 CD4 分类、低基线血红蛋白水平、ART 副作用、未服用 IPT 和基线慢性病合并症等预测因素的 HIV 阳性患者进行密切随访和监测。因此，我们建议采取有针对性和基于证据的策略来应对 OIs 负担并改善结局。
