埃塞俄比亚南部霍萨纳市尼吉斯特·埃莱尼·穆罕默德纪念综合专科医院接受抗逆转录病毒治疗的成年患者实现病毒载量抑制的时间及其预测因素
Time to Viral Load Suppression and Its Predictors Among Adult Patients on Antiretro Viral Therapy in Nigist Eleni Mohammed Memorial Comprehensive Specialized Hospital, Hossana, Southern Ethiopia.
作者信息
Erjino Eshetu, Abera Ermias, Lemma Tirore Lire
机构信息
Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Sothern Ethiopia.
出版信息
HIV AIDS (Auckl). 2023 Apr 20;15:157-171. doi: 10.2147/HIV.S408565. eCollection 2023.
BACKGROUND
Unsuppressed viral load count in patients on anti-retroviral therapy is linked to poorer survival and increased transmission of the virus. Despite efforts made in Ethiopia, the viral load suppression rate is still low.
OBJECTIVE
To estimate time to viral load suppression and predictors of viral load suppression among adults on anti-retroviral therapy in Nigist Elen Mohamed Memorial Comprehensive Specialized Hospital, 2022.
MATERIALS AND METHODS
A retrospective follow-up study was conducted among 297 adults on anti-retroviral therapy from January 1, 2016, to December 31, 2021. A simple random sampling technique was used to select study participants. The data were analyzed using STATA 14. Cox regression model was used. The adjusted hazard ratio with 95% CI was estimated.
RESULTS
A total of 296 records of patients on anti-retroviral therapy were included in this study. The incidence of viral load suppression was 9.68 per 100-person months. The median time for viral load suppression was 9 months. Patients with baseline CD4 ≥200 cell/mm (AHR: 1.87; 95% CI = 1.34, 2.63), who had no opportunistic infections (AHR = 1.84; 95% CI = 1.34, 2.52), who were on WHO clinical stage-I or II (AHR = 2.12; 95% CI = 1.18, 3.79) and who have taken tuberculosis preventive therapy (AHR = 2.24; 95% CI = 1.66, 3.02) had higher hazards of viral load suppression.
CONCLUSION
The median time for viral load suppression was 9 months. Patients who had no opportunistic infection, with higher CD4 count, on WHO clinical stage-I or II, who have taken tuberculosis preventive therapy had higher hazards of viral load suppression. Careful monitoring and counseling of patients with CD4 levels lower than 200 cells/mm3 are necessary. Careful monitoring and counseling of patients in advanced WHO clinical stages, with lower CD4 count levels and with opportunistic infections is crucial. Strengthening the provision of tuberculosis preventive therapy is warranted.
背景
接受抗逆转录病毒治疗的患者中,病毒载量未得到抑制与较差的生存率及病毒传播增加有关。尽管埃塞俄比亚已做出努力,但病毒载量抑制率仍然很低。
目的
估计2022年在尼吉斯特·埃伦·穆罕默德纪念综合专科医院接受抗逆转录病毒治疗的成年人实现病毒载量抑制的时间以及病毒载量抑制的预测因素。
材料与方法
对2016年1月1日至2021年12月31日期间297名接受抗逆转录病毒治疗的成年人进行回顾性随访研究。采用简单随机抽样技术选择研究参与者。使用STATA 14对数据进行分析。采用Cox回归模型。估计调整后的风险比及95%置信区间。
结果
本研究共纳入296例接受抗逆转录病毒治疗患者的记录。病毒载量抑制发生率为每100人月9.68例。病毒载量抑制的中位时间为9个月。基线CD4≥200个细胞/mm³的患者(调整后风险比:1.87;95%置信区间=1.34,2.63)、无机会性感染的患者(调整后风险比=1.84;95%置信区间=1.34,2.52)、处于世界卫生组织临床I期或II期的患者(调整后风险比=2.12;95%置信区间=1.18,3.79)以及接受过结核病预防性治疗的患者(调整后风险比=2.24;95%置信区间=1.66,3.02)实现病毒载量抑制的风险更高。
结论
病毒载量抑制的中位时间为9个月。无机会性感染、CD4计数较高、处于世界卫生组织临床I期或II期且接受过结核病预防性治疗的患者实现病毒载量抑制的风险更高。对CD4水平低于200个细胞/mm³的患者进行仔细监测和咨询很有必要。对处于世界卫生组织临床晚期、CD4计数较低且有机会性感染的患者进行仔细监测和咨询至关重要。有必要加强结核病预防性治疗的提供。