Centro Integrado de Cuidados e Tratamento, Hospital Militar de Maputo, Maputo P.O. Box 21414368/9, Mozambique.
Global Health and Tropical Medicine (GHTM), Associate Laboratory in Translation and Innovation Towards Global Health (LA-REAL), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
Viruses. 2023 Sep 22;15(10):1978. doi: 10.3390/v15101978.
Access to antiretroviral treatment (ART) is increasingly available worldwide; however, the number of patients lost to follow-up and number of treatment failures continue to challenge most African countries.
To analyse the retention in clinical care and the virological response and their associated factors of HIV-1 patients from the Maputo Military Hospital (MMH).
A cross-sectional observational study was conducted to analyse data from patients who started ART between 2016 and 2018 in the MMH.
At the end of 12 months, 75.1% of 1247 patients were active on clinical follow-up and 16.8% had suspected virologic failure (VL > 1000 copies/mm). Patients younger than 40 years old were more likely to be lost to follow-up when compared to those aged >50 years old, as well as patients who were unemployed and patients with a CD4 count < 350 cells/mm. Patients with haemoglobin levels lower than 10 g/dL and with a CD4 count < 350 cells/mm were more likely to have virological failure.
We have identified clinical and sociodemographic determinants of loss to follow-up and in the development of virological failure for HIV-positive patients in clinical care in the MMH. Therefore, HIV programs must consider these factors to increase the screening of patients at high risk of poor outcomes and particularly to strengthen adherence counselling programs.
抗逆转录病毒治疗（ART）的可及性在全球范围内日益增加；然而，失访患者人数和治疗失败人数仍在继续挑战大多数非洲国家。
分析马普托军事医院（MMH）HIV-1 患者的临床护理保留率、病毒学反应及其相关因素。
对 2016 年至 2018 年期间在 MMH 开始接受 ART 的患者进行了一项横断面观察性研究，分析了这些患者的数据。
在 12 个月结束时，1247 名患者中有 75.1%在临床随访中保持活跃，16.8%有疑似病毒学失败（VL>1000 拷贝/毫米）。与年龄>50 岁的患者相比，年龄<40 岁的患者失访的可能性更高，失业患者和 CD4 计数<350 个细胞/毫米的患者也是如此。血红蛋白水平<10 g/dL 和 CD4 计数<350 个细胞/毫米的患者更有可能发生病毒学失败。
我们已经确定了 MMH 临床护理中 HIV 阳性患者失访和病毒学失败的临床和社会人口统计学决定因素。因此，艾滋病毒规划必须考虑这些因素，以增加对高风险不良结局患者的筛查，特别是要加强遵医嘱咨询方案。
