Department of Internal Medicine, Fatmawati General Hospital, Jakarta, Indonesia.
General Practitioner Staff, Fatmawati General Hospital, Jakarta, Indonesia.
J Prev Med Public Health. 2024 May;57(3):252-259. doi: 10.3961/jpmph.23.512. Epub 2024 Apr 30.
This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment.
A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years.
In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72).
Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.
本研究旨在调查与艾滋病毒感染者（HIV）在接受抗逆转录病毒治疗（ART）的前 3 年中坚持治疗相关的因素。
在印度尼西亚雅加达的一家三级医院进行了一项回顾性研究，使用电子健康记录。纳入了 2010 年至 2020 年期间开始接受 ART 的成年 HIV 阳性患者。采用二元逻辑回归模型来确定与前 3 年 ART 保留相关的因素。
共有 535 名受访者纳入分析。第一年、第二年和第三年的 ART 保留率分别为 83.7%、79.1%和 77.2%。多变量分析显示，开始 ART 时的 CD4 计数与保留呈负相关。CD4 计数>200 个细胞/毫升的患者保留良好的可能性比 CD4 计数≤200 个细胞/毫升的患者低 0.65 倍。开始 ART 的年份也与保留显著相关。与 2017-2020 年开始 ART 的患者相比，2010-2013 年或 2014-2016 年开始 ART 的患者保留良好的可能性较小，调整后的优势比分别为 0.52 和 0.40。接受依非韦伦为基础的治疗的患者保留良好的可能性是接受奈韦拉平的患者的 1.69 倍（95%置信区间，1.05 至 2.72）。
我们的研究显示，第三年的 ART 保留率下降。CD4 计数、登记年份和基于依非韦伦的方案与保留显著相关。患者参与一直是 HIV 项目的重点，已经实施了干预措施来解决这个问题。
