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2019冠状病毒病对艾滋病毒感染者治疗依从性的影响

Impact of COVID-19 on Adherence to Treatment in Patients with HIV.

作者信息

Carbonero-Lechuga Pablo, Castrodeza-Sanz Javier, Sanz-Muñoz Iván, Marqués-Sánchez Pilar, Eiros Jose M, Dueñas-Gutiérrez Carlos, Prada-García Camino

机构信息

Department of Preventive Medicine and Public Health, University of Valladolid, 47005 Valladolid, Spain.

Preventive Medicine and Public Health Service, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain.

出版信息

Healthcare (Basel). 2023 May 2;11(9):1299. doi: 10.3390/healthcare11091299.

Abstract

In patients with human immunodeficiency virus (HIV), adherence to treatment is affected by the adverse effects of treatment, the presence of additional comorbidities, the complexity of dosage, and family and community support. However, one recent circumstance that was likely to have influenced therapeutic adherence was the COVID-19 pandemic and the applied containment measures. An observational retrospective study of a sample of patients with HIV was conducted to establish the relationship between sociodemographic, clinical, and pharmacological variables and therapeutic adherence before and after the pandemic. Adherence was measured using the validated simplified medication adherence questionnaire (SMAQ) and medication possession rate. A statistical analysis was performed to determine the mean, standard deviation, and median of the quantitative variables and the frequencies of the qualitative variables, and the relationship between the dependent and independent variables was analysed using the chi-squared test and Student's -test. No statistically significant differences were found between treatment adherence measured before and 22 months after the start of the pandemic. Sex, occupation, treatment regimen, viral load levels, and COVID-19 disease status did not influence adherence during either period. However, the age of patients with HIV had an impact on adherence during both periods ( = 0.008 and = 0.002, respectively), with the age group under 45 years being less adherent. In addition, experiencing adverse drug reactions (ADRs) was shown to have an impact on adherence before the pandemic ( = 0.006) but not afterwards. The COVID-19 pandemic was not shown to have an impact on the degree of adherence to antiretroviral treatment in patients with HIV. Instead, adherence was influenced by patient age and ADR occurrence; therefore, measures must be taken in this regard. The SMAQ demonstrated sensitivity in assessing adherence.

摘要

在人类免疫缺陷病毒(HIV)感染者中,治疗依从性受到治疗副作用、是否存在其他合并症、用药剂量的复杂性以及家庭和社区支持的影响。然而,近期一个可能影响治疗依从性的情况是2019冠状病毒病(COVID-19)大流行及所采取的防控措施。开展了一项针对HIV感染者样本的观察性回顾性研究,以确定大流行前后社会人口学、临床和药理学变量与治疗依从性之间的关系。使用经过验证的简化药物依从性问卷(SMAQ)和药物持有率来衡量依从性。进行统计分析以确定定量变量的均值、标准差和中位数以及定性变量的频率,并使用卡方检验和学生t检验分析因变量和自变量之间的关系。在大流行开始前和开始22个月后所测量的治疗依从性之间未发现统计学上的显著差异。性别、职业、治疗方案、病毒载量水平和COVID-19疾病状态在这两个时期均未影响依从性。然而,HIV感染者的年龄在这两个时期均对依从性有影响(分别为P = 0.008和P = 0.002),45岁以下年龄组的依从性较低。此外,在大流行之前,出现药物不良反应(ADR)被证明对依从性有影响(P = 0.006),但之后则没有。未显示COVID-19大流行对HIV感染者抗逆转录病毒治疗的依从程度有影响。相反,依从性受患者年龄和ADR发生情况的影响;因此,必须在这方面采取措施。SMAQ在评估依从性方面表现出敏感性。

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HIV and COVID-19: review of clinical course and outcomes.HIV 和 COVID-19:临床过程和结局的综述。
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