Department of Public Service, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
Department of Nursing, Beijing Ditan Hospital Capital Medical University, Beijing, China.
BMC Geriatr. 2022 Sep 5;22(1):728. doi: 10.1186/s12877-022-03411-x.
Debate has persisted regarding whether PLWH with longer HIV durations have lower levels of prevalence and severity of symptoms compared with their newly diagnosed counterparts. Whether and how the HIV duration impact the symptom distress among middle-aged and older PLWH has not been explored clearly.
The patients with HIV-infected aged more than 40 years old were included from seven designated medical institutions of seven regions in China. Outcome was the score of symptom distress. We used the multiple regression model to calculate adjusted Coefficient of Regression (β) with 95% CI in this study.
Among 210 participants (mean age 50.8 years; 71.0% male; 68.1% at asymptomatic stage) in the study, the median number of symptoms was 5. Of all symptoms reported, the most distressed symptoms were sleep disturbance (33.33%), followed by memory loss (31.90%), fatigue (26.67%), slow reactions (22.86%), and vision blur (21.90%). All participants were divided into four groups according to HIV duration, and the median of total score of symptom ditress among all participants was 0.1(0.0,0.9). Difference of total scores and clusters' scores of symptom distress among four HIV duration groups were statistically significant. 51 participants with 6-10 years HIV duration were more likely to be higher level of education, at asymptomatic stage and have higher CD4 + T cell count. After adjustment for gender, age, race, education, marital status, employment, family income, region, stage of disease and CD4 + T cell count, the score of symptom distress among participants with 6-10 years HIV duration had was higher with the extension of HIV duration. Specially in physical symptoms and psychological symptoms,participants with 6-10 years HIV duration reported the persisting worse burdensome.
HIV duration with 6-10 yearsmay be a key period that the medical team needs to pay special attention to among middle-aged and elderly PLWH. There is a need to provide medical and psychosocial services targeting middle-aged and elderly PLWH according to their changing symptom distress.
Clinicaltrials.gov: ChiCTR2100046225. Registered 11 May 2021.
关于 HIV 感染时间较长的 PLWH 与新诊断的患者相比,其症状的流行率和严重程度是否较低,一直存在争议。HIV 持续时间如何影响中老年 PLWH 的症状困扰尚未得到明确探讨。
本研究纳入了来自中国七个地区七个指定医疗机构的年龄在 40 岁以上的 HIV 感染患者。结局为症状困扰评分。我们使用多元回归模型计算了该研究中具有 95%置信区间的调整回归系数(β)。
在本研究的 210 名参与者(平均年龄 50.8 岁;71.0%为男性;68.1%处于无症状期)中,报告的中位数症状数为 5 个。在所有报告的症状中,最困扰的症状是睡眠障碍(33.33%),其次是记忆力减退(31.90%)、疲劳(26.67%)、反应迟钝(22.86%)和视力模糊(21.90%)。所有参与者根据 HIV 持续时间分为四组,所有参与者的总症状困扰评分中位数为 0.1(0.0,0.9)。四组 HIV 持续时间的总评分和症状困扰聚类评分存在统计学差异。51 名 HIV 持续时间为 6-10 年的参与者更有可能接受过高等教育,处于无症状期,CD4+T 细胞计数更高。在校正性别、年龄、种族、教育程度、婚姻状况、就业状况、家庭收入、地区、疾病阶段和 CD4+T 细胞计数后,HIV 持续时间为 6-10 年的参与者的症状困扰评分随着 HIV 持续时间的延长而升高。特别是在身体症状和心理症状方面,HIV 持续时间为 6-10 年的参与者报告的负担持续加重。
HIV 持续时间为 6-10 年可能是中老年 PLWH 中医疗团队需要特别关注的关键时期。需要根据中老年 PLWH 不断变化的症状困扰,为他们提供有针对性的医疗和心理社会服务。
Clinicaltrials.gov:ChiCTR2100046225。注册于 2021 年 5 月 11 日。