Senkatana Antiretroviral Therapy (ART) Clinic Maseru, Maseru, Lesotho.
School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Pan Afr Med J. 2023 Nov 2;46:74. doi: 10.11604/pamj.2023.46.74.40122. eCollection 2023.
sub-Saharan Africa, home to over 10% of the world´s population, is the worst Human Immunodeficiency Virus (HIV)-affected region in the world. HIV/AIDS is a major public health challenge in Lesotho, with an HIV prevalence of 25.6% in 2018. The aim of this study was to evaluate the treatment outcomes of people living with HIV (PLHIV) on antiretroviral therapy (ART) after 48 months of initiation.
we conducted a register-based retrospective cohort study for all patients registered at the Senkatana ART Clinic from January to December 2014 and followed them for 48 months until 2018. The ART treatment register and treatment cards were the primary source of data. Data were captured and cleaned in Epi info version 7 and exported into Stata version 14 for analysis. Descriptive statistics were used to describe participant characteristics. Due to the lack of incident data, the factors associated with treatment outcomes were determined using Chi-square tests and logistic regression.
in 2014, 604 patients were enrolled on ART, of which the majority were female (59.4%) and married (54.8%). The mean age (standard deviation (SD)) at which ART was started was 36 years (10.5) years. After 48 months of initiation, the cohort consisted of 387 patients of which 365 (94.3%) were retained on treatment. In the multivariable logistic regression model, neither demographic characteristics nor clinical factors were associated with ART treatment outcome (viral load suppression, adherence, or ART retention), however, the univariable analysis showed that higher CD4 count at initiation was associated with viral load suppression.
retention, viral load suppression, and adherence were generally good in this cohort after 48 months of initiation. CD4 at initiation was a significant predictor of viral load suppression at 48 months. The ART programme has managed to maintain high viral load suppression and improve immunity in patients who are immunocompromised. Proper data quality management is required for adequate patient monitoring to enable clinical personnel to record and use individual patient data for guiding the clinical management of such patients. Strengthening patient support and tracing will help to reduce the number of patients lost to follow-up.
撒哈拉以南非洲拥有世界 10%以上的人口，是世界上受人类免疫缺陷病毒（HIV）影响最严重的地区。HIV/AIDS 是莱索托的一个主要公共卫生挑战，2018 年 HIV 流行率为 25.6%。本研究旨在评估在开始抗逆转录病毒治疗（ART）后 48 个月时接受 HIV 感染者（PLHIV）的治疗结果。
我们对 2014 年 1 月至 12 月期间在 Senkatana ART 诊所登记的所有患者进行了基于登记的回顾性队列研究，并对他们进行了 48 个月的随访，直到 2018 年。ART 治疗登记册和治疗卡是主要的数据来源。使用 Epi info 版本 7 捕获和清理数据，并将其导出到 Stata 版本 14 进行分析。使用描述性统计来描述参与者的特征。由于缺乏发病数据，使用卡方检验和逻辑回归确定了与治疗结果相关的因素。
2014 年，604 名患者开始接受 ART 治疗，其中大多数为女性（59.4%）和已婚（54.8%）。开始接受 ART 的平均年龄（标准差（SD））为 36 岁（10.5）岁。启动后 48 个月，该队列由 387 名患者组成，其中 365 名（94.3%）继续接受治疗。在多变量逻辑回归模型中，人口统计学特征和临床特征均与 ART 治疗结果（病毒载量抑制、依从性或 ART 保留）无关，但单变量分析表明，起始时较高的 CD4 计数与病毒载量抑制相关。
在开始治疗 48 个月后，该队列的保留率、病毒载量抑制率和依从率总体良好。启动时的 CD4 是 48 个月时病毒载量抑制的显著预测因子。ART 项目成功地维持了高病毒载量抑制，并改善了免疫功能低下患者的免疫功能。需要适当的数据质量管理，以便对患者进行充分监测，使临床人员能够记录和使用个别患者的数据，为这类患者的临床管理提供指导。加强患者支持和跟踪将有助于减少失访患者的数量。
