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埃塞俄比亚南部沃莱塔索多大学综合专科医院接受抗逆转录病毒治疗的成年人类免疫病毒感染患者的死亡率及其预测因素:一项回顾性随访研究。

Incidence of Mortality and Its Predictors Among Adult Human Immune Virus Infected Patients on Antiretroviral Therapy in Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: A Retrospective Follow-Up Study.

作者信息

Barata Tagese Yakob, Abiso Girumneh, Israel Eskinder, Molla Simegn, Wolka Eskinder

机构信息

Department of Public Health Emergency, Institute of Bele Awassaa Health Office, Wolaita, Ethiopia.

Department of Infection Prevention and Health Promotion, Institute of Sodo Town Health Office, Wolaita, Ethiopia.

出版信息

HIV AIDS (Auckl). 2023 Jun 19;15:361-375. doi: 10.2147/HIV.S401155. eCollection 2023.

Abstract

BACKGROUND

Although the goal of ART is to have better health, extend the life of the HIV-infected patient, and decrease HIV-related death, there is a continuation of HIV-related mortality with the use of ART. This study aimed to assess the incidence of mortality and its predictors among adult HIV/AIDS patients who were on ART follow-up at Wolaita Sodo Comprehensive specialized hospital in southern Ethiopia.

METHODS

A retrospective follow-up study was conducted from May 1 to June 30, 2021 among adult HIV/AIDS patients with a total of 441 adult HIV/AIDS patients in this hospital included. Kaplan-Meier failure curve and Log rank test were fitted, and Cox-proportional hazards model was also used to identify the predictors of mortality. Both crude and adjusted hazard ratios (AHR) with their 95% confidence interval (CI) were calculated to show the strength of association. The proportional assumption was conducted by using a global test based on the Schoenfeld residuals.

RESULTS

Incidence of the mortality rate was 5.61 (95% CI, 4.2-7.3) per 100 person-years observation. In the multivariable analysis, HIV/AIDS patients were widowed (aHR; 10.9 (95% CI, 3.13-37.99), poorly drug-adhered (aHR; 5.6 (95% CI, 2.4-13.2) and fair adhered (aHR; 3.53 (95% CI, 1.58-7.87), WHO clinical stage IV (aHR; 5.91, (95% CI, 1.41-24.71), history of substance use (aHR; 2.02 (95% CI, 1.01-4.06) and history of IV drug use (aHR; 2.26 (95% CI, 1.10-4.74) independently predicted the mortality of patients.

CONCLUSION

In this study, incidence of mortality was relatively high. The rate of mortality may be minimized by paying particular attention to individuals with widowing, substance use at the baseline, advanced clinical stage IV, history of IV drug use at the baseline, and those with adherence problems.

摘要

背景

尽管抗逆转录病毒治疗(ART)的目标是改善健康状况、延长艾滋病毒感染患者的生命并降低与艾滋病毒相关的死亡,但在使用ART的情况下,与艾滋病毒相关的死亡率仍在持续。本研究旨在评估在埃塞俄比亚南部沃莱塔索多综合专科医院接受ART随访的成年艾滋病毒/艾滋病患者的死亡率及其预测因素。

方法

于2021年5月1日至6月30日对成年艾滋病毒/艾滋病患者进行了一项回顾性随访研究,该医院共纳入441例成年艾滋病毒/艾滋病患者。拟合了Kaplan-Meier失败曲线和对数秩检验,并使用Cox比例风险模型来确定死亡率的预测因素。计算了粗风险比和调整后风险比(AHR)及其95%置信区间(CI)以显示关联强度。比例假设通过基于Schoenfeld残差的全局检验进行。

结果

每100人年观察期的死亡率为5.61(95%CI,4.2 - 7.3)。在多变量分析中,艾滋病毒/艾滋病患者丧偶(调整后风险比;10.9(95%CI,3.13 - 37.99)、药物依从性差(调整后风险比;5.6(95%CI,2.4 - 13.2)和依从性一般(调整后风险比;3.53(95%CI,1.58 - 7.87)、世界卫生组织临床分期IV期(调整后风险比;5.91,(95%CI,1.41 - 24.71)、有物质使用史(调整后风险比;2.02(95%CI,1.01 - 4.06)和有静脉吸毒史(调整后风险比;2.26(95%CI,1.10 - 4.74)独立预测了患者的死亡率。

结论

在本研究中,死亡率相对较高。通过特别关注丧偶者、基线时有物质使用情况者、临床IV期晚期患者、基线时有静脉吸毒史者以及有依从性问题的患者,可将死亡率降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b659/10289094/80045e04afc1/HIV-15-361-g0001.jpg

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