二级医疗机构中HIV感染成人的病毒抑制情况及药物相关负担评估。

Evaluation of viral suppression and medication-related burden among HIV-infected adults in a secondary care facility.

作者信息

Hedima Erick Wesley, Ohieku John David, David Emmanuel Agada, Ikunaiye Nasiru Yakubu, Nasir Abdulrahman, Alfa Mustapha Ahmed, Abubakar Safinat, Bwiyam Ismaila Khalifas, Bitrus Tang'an Zughumnaan

机构信息

Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Gombe State University, Nigeria.

Department of Clinical Pharmacy and Pharmacy Administration, Faculty of Pharmacy, University of Maiduguri, Nigeria.

出版信息

Explor Res Clin Soc Pharm. 2024 Jul 4;15:100473. doi: 10.1016/j.rcsop.2024.100473. eCollection 2024 Sep.

DOI:10.1016/j.rcsop.2024.100473

PMID:39108330

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11301334/

Abstract

BACKGROUND

People living with HIV/AIDS (PLHIV) are prone to other health issues that may result from the disease or antiretroviral medicines. These persons experience other psychosocial aspects of the illness, which may negatively affect their quality of life and overall treatment outcomes. This study assessed the medication-related burden and virological response of adult PLHIV.

METHOD

This cross-sectional study involved 417 HIV-positive adults who had been on combined antiretroviral therapy for at least a year at the State Specialist Hospital Gombe. Nigeria. Patient medication experience was measured using the Living with Medication Questionnaire version-3 (LMQ-3). Virological suppression was assessed at viral loads <1000 copies/ml and 20 copies/ml for undetectable HIV RNA levels. The LMQ-3 scores were compared with the participants' characteristics using independent -tests or one-way analysis of variance (ANOVA). Regression analyses was employed to identify the predictors of viral suppression and medication-related burden. value <0.05 at 95% confidence interval was considered statistically significant.

RESULTS

Of the 417 PLHIV included in this study, 271 (65%) were classified as WHO Stage 1 ART initiation, 93.8% achieved viral suppression with 291 (69.5%) whom were females. The majority of patients 382 (91.6%) were on a dolutegravir-based regimen, had no tuberculosis diagnosis at antiretroviral therapy (ART) initiation (82.5%) and were 6-10 years on ART (46.3%). Only 67.6% of the population had a moderate medication-related burden. Female sex ( < 0.0005), unsuppressed viral load ( = 0.01), second-line ART ( = 0.03), tuberculosis at ART initiation ( = 0.02), and employment ( = 0.003) were significantly associated with medication-related burden. The predictor of viral suppression was high degree of medication-related burden (AOR, 0.12; 95% CI, 0.02-0.59) while unsuppressed viral load ( = 0.01) and female gender ( = 0.002) were independent predictors of medication related burden.

CONCLUSION

The findings from this study revealed that majority of the patients achieved viral suppression with moderate degree of medication-related burden. Targeted interventions should be directed toward younger patients, females and patients with unsuppressed viral loads.

摘要

背景

感染艾滋病毒/艾滋病的人（PLHIV）容易出现由该疾病或抗逆转录病毒药物引起的其他健康问题。这些人还经历疾病的其他心理社会方面，这可能对他们的生活质量和整体治疗结果产生负面影响。本研究评估了成年PLHIV的药物相关负担和病毒学反应。

方法

这项横断面研究纳入了417名在尼日利亚贡贝州立专科医院接受至少一年联合抗逆转录病毒治疗的艾滋病毒阳性成年人。使用生活用药问卷第3版（LMQ-3）来衡量患者的用药体验。对于无法检测到的艾滋病毒RNA水平，在病毒载量<1000拷贝/毫升和<20拷贝/毫升时评估病毒学抑制情况。使用独立样本t检验或单因素方差分析（ANOVA）将LMQ-3得分与参与者的特征进行比较。采用回归分析来确定病毒抑制和药物相关负担的预测因素。在95%置信区间内，P值<0.05被认为具有统计学意义。

结果

在本研究纳入的417名PLHIV中，271名（65%）被归类为世界卫生组织1期开始接受抗逆转录病毒治疗，93.8%实现了病毒抑制，其中291名（69.5%）为女性。大多数患者382名（91.6%）采用基于多替拉韦的治疗方案，在开始抗逆转录病毒治疗（ART）时没有结核病诊断（82.5%），并且接受ART治疗6至10年（46.3%）。只有67.6%的人群有中度药物相关负担。女性（P<0.0005）、病毒载量未被抑制（P=0.01）、二线ART治疗（P=0.03）、开始ART时患有结核病（P=0.02）和就业情况（P=0.003）与药物相关负担显著相关。病毒抑制的预测因素是高度的药物相关负担（调整后比值比，0.12；95%置信区间，0.02-0.59），而病毒载量未被抑制（P=0.01）和女性性别（P=0.002）是药物相关负担的独立预测因素。