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揭示多拉韦林时代接受高效抗逆转录病毒治疗的成年人贫血的流行情况及其预测因素:一项回顾性横断面研究。

Unveiling the prevalence of anaemia and its predictors among adults on highly active antiretroviral therapy in the dolutegravir era: a retrospective cross-sectional study.

机构信息

School of Pharmacy Department of Pharmacology and Toxicology, Debre Tabor University, Debre Tabor, Ethiopia

School of Pharmacy Department of Pharmacology and Toxicology, Debre Tabor University, Debre Tabor, Ethiopia.

出版信息

BMJ Open. 2024 Sep 5;14(9):e086480. doi: 10.1136/bmjopen-2024-086480.

Abstract

OBJECTIVE

This study examined the prevalence, severity and risk factors of anaemia among adult people living with HIV attending an antiretroviral therapy centre in Woreta Primary Hospital, Woreta town, Ethiopia.

DESIGN

Hospital-based retrospective cross-sectional study.

SETTING

Public health facility that provides HIV care in Woreta town.

PARTICIPANTS

A total of 289 medical records of adults living with HIV/AIDS on highly active antiretroviral therapy from February 2019 to September 2023 at government hospital were reviewed using a systematic sampling method. The data were entered using Epi-info V.7 and exported to SPSS V.23 for data analysis. The data were analysed using bivariate and then multivariate logistic regression models in order to identify variables associated with anaemia. At the 95% CI level, variables having a p value of <0.05 were deemed to be statistically significant predictors.

PRIMARY OUTCOME

Prevalence and severity of anaemia and its predictors among adult patients living with HIV on antiretroviral therapy in Woreta Primary Hospital.

RESULTS

The total prevalence of anaemia was 31.5% (95% CI 28.9 to 33.8). The prevalence of mild, moderate and severe anaemia was 20.42%, 10.38% and 0.70%, respectively. Predictors independently linked with anaemia were female sex (adjusted OR (AOR) 1.08), age ≥40 years (AOR 1.21), lived with HIV >10 years (AOR 2.31), CD4 counts <200 cells/µL (AOR 3.81), non-suppressed viral load (AOR 1.28), history of opportunistic infections (AOR 1.54), WHO clinical stages III and IV (AOR 1.37 and 2.23, respectively) and history of parasitic infestation (AOR 2.81).

CONCLUSIONS

A sizeable proportion of participants were found anaemic. Female sex, older age, longer periods lived with the virus, lower CD4 count, non-suppressed viral load, history of opportunistic infections, WHO clinical stages III and IV and history of parasitic infestation were the contributing factors. Therefore, to improve the anaemic status and living circumstances of patients living with HIV, immediate action on the linked factors is needed, such as monitoring for maintenance of CD4 counts >200 cells/μL and avoiding progression of HIV to the advanced WHO clinical stages, suppressed viral load, preventing opportunistic infections and parasitic infestation.

摘要

目的

本研究旨在调查在埃塞俄比亚沃雷塔镇沃雷塔初级医院接受抗逆转录病毒疗法的成年艾滋病毒感染者中贫血的患病率、严重程度和危险因素。

设计

基于医院的回顾性横断面研究。

地点

在沃雷塔镇提供艾滋病毒护理的公共卫生机构。

参与者

采用系统抽样法,对 2019 年 2 月至 2023 年 9 月期间在政府医院接受高效抗逆转录病毒疗法的 289 名艾滋病毒/艾滋病成年患者的医疗记录进行了回顾。数据使用 Epi-info V.7 输入,并导出到 SPSS V.23 进行数据分析。使用双变量和多变量逻辑回归模型分析数据,以确定与贫血相关的变量。在 95%置信区间水平上,p 值<0.05 的变量被认为是具有统计学意义的预测因子。

主要结局

沃雷塔初级医院接受抗逆转录病毒治疗的成年艾滋病毒感染者贫血的患病率和严重程度及其预测因素。

结果

贫血总患病率为 31.5%(95%置信区间 28.9-33.8)。轻度、中度和重度贫血的患病率分别为 20.42%、10.38%和 0.70%。与贫血独立相关的预测因素为女性(调整后的比值比(AOR)1.08)、年龄≥40 岁(AOR 1.21)、感染艾滋病毒>10 年(AOR 2.31)、CD4 计数<200 个/µL(AOR 3.81)、未抑制的病毒载量(AOR 1.28)、机会性感染史(AOR 1.54)、世界卫生组织临床分期 III 和 IV 期(AOR 1.37 和 2.23)和寄生虫感染史(AOR 2.81)。

结论

相当一部分参与者贫血。女性、年龄较大、感染病毒时间较长、CD4 计数较低、病毒载量未得到抑制、有机会性感染史、世界卫生组织临床分期 III 和 IV 期以及寄生虫感染史是导致贫血的因素。因此,为了改善艾滋病毒感染者的贫血状况和生活环境,需要立即针对相关因素采取行动,如监测 CD4 计数>200 个/µL 的维持情况,并避免艾滋病毒进展至晚期世界卫生组织临床分期、抑制病毒载量、预防机会性感染和寄生虫感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d45e/11590816/d6f08b959fdc/bmjopen-14-9-g001.jpg

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