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优化艾滋病护理:古吉拉特邦南部一家三级护理中心关于CD4细胞计数、病毒载量及人口统计学因素的见解

Optimizing HIV care: Insights from CD4 count, viral load, and demographic factors in a tertiary care centre of South Gujarat.

作者信息

Kanani Komal, Rajdev Sangita, Mullan Summaiya

机构信息

Department of Microbiology, Government Medical College & New Civil Hospital, Surat, Gujarat, India.

出版信息

Indian J Med Microbiol. 2024 Sep-Oct;51:100696. doi: 10.1016/j.ijmmb.2024.100696. Epub 2024 Aug 7.

Abstract

PURPOSE

Despite advancements in prevention, diagnosis, and treatment, HIV/AIDS remains a critical health concern, particularly in India. This study contributes valuable insights into HIV management strategies. This prospective and retrospective longitudinal observational study aimed to analyze the trends in CD4 cell count and viral load suppression among adult People Living with HIV (PLHIV) undergoing antiretroviral therapy (ART) and evaluate the influence of demographic factors and ART adherence on these parameters at the ART Centre of New Civil Hospital, Surat, India.

MATERIALS & METHODS: Adult PLHIV registered and initiated on ART between June 2017 and May 2018 at ART-NCH, Surat with Continuous follow-up until 2023 were included in the study. Data was collected and Statistical analysis was performed using Microsoft Excel and SPSS software. Other factors were evaluated for their influence on treatment outcomes.

RESULTS

A longitudinally analyzed data from 365 adult PLHIV receiving ART with continuous follow-up until 2023 revealed significant trends, with CD4 counts increasing from 425 (1st month) to 612.67 (24th month), indicating improving immune function. Individuals on first-line ART regimens had significantly higher odds (OR: 3.5, 95 % CI: 1.1-11.3) of achieving CD4 counts ≥350 compared to those on second-line regimens. Adherence to treatment (OR: 1.98, 95 % CI: 1.1-3.4) also increased the odds of attaining CD4 counts ≥350. Viral load suppression was achieved in 353 out of 365 participants.

CONCLUSION

This study highlights the need for tailored interventions to optimize immune recovery and viral load suppression among PLHIV. Recommendations include targeted intervention to improve long-term health outcomes.

摘要

目的

尽管在预防、诊断和治疗方面取得了进展,但艾滋病毒/艾滋病仍然是一个严重的健康问题,尤其是在印度。本研究为艾滋病毒管理策略提供了有价值的见解。这项前瞻性和回顾性纵向观察研究旨在分析接受抗逆转录病毒治疗(ART)的成年艾滋病毒感染者(PLHIV)的CD4细胞计数和病毒载量抑制趋势,并评估人口统计学因素和ART依从性对印度苏拉特新市民医院ART中心这些参数的影响。

材料与方法

2017年6月至2018年5月在苏拉特ART-NCH登记并开始接受ART治疗且持续随访至2023年的成年PLHIV被纳入研究。收集数据并使用Microsoft Excel和SPSS软件进行统计分析。评估其他因素对治疗结果的影响。

结果

对365名接受ART治疗并持续随访至2023年的成年PLHIV进行纵向分析的数据显示出显著趋势,CD4计数从425(第1个月)增加到612.67(第24个月),表明免疫功能有所改善。与接受二线治疗方案的患者相比,接受一线ART治疗方案的患者CD4计数≥350的几率显著更高(OR:3.5,95%CI:1.1-11.3)。坚持治疗(OR:1.98,95%CI:1.1-3.4)也增加了CD4计数≥350的几率。365名参与者中有353人实现了病毒载量抑制。

结论

本研究强调需要采取针对性干预措施,以优化PLHIV的免疫恢复和病毒载量抑制。建议包括有针对性的干预措施,以改善长期健康结果。

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