Muhie Nurye Seid
Department of Statistics Mekdela Amba University, Tulu Awulia, Ethiopia.
J Trop Med. 2024 Sep 5;2024:8461788. doi: 10.1155/2024/8461788. eCollection 2024.
HIV is one of the most significant worldwide health concerns of the twenty-first century and a serious threat to human society. Hemoglobin level and CD4 cell count are two of the most important biomarkers of HIV progression and patient survival. The objective of this study was to identify common risk factors associated with CD4 cell count and hemoglobin level among adult female HIV-positive patients treated with ART at the University of Gondar Comprehensive Specialized Hospital, Ethiopia.
The source of data in this study was secondary data conducted in the University of Gondar Comprehensive Specialized Hospital from September 2015 to March 2022 . Data exploration in this study was normal histogram plot, box plot, and Q-Q plot considered to gain some visions of the data related to CD4 cell count and hemoglobin level. A Bayesian joint model was used in this longitudinal data set to get a wide range of information about adult female HIV-patients.
The mean with a standard deviation of hematocrit (%), red blood cell (10/), lymphocyte (%), and weight (kg) of female patients were 37.2 (3.8), 4.0 (1.6), 43.6 (11.8), and 44.9 (9.4), respectively. In this study, the random intercept model for CD4 cell count and the random intercept and slope model for hemoglobin level were considered as the best selected model. Visit time, hematocrit, weight, RBC, lymphocyte count, educational status, marital status, disclosure, and substance use were common risk factors for CD4 cell count and hemoglobin level.
This study concluded that, the risk factors visit time, weight, secondary educators, tertiary educators, married patients, patients who disclosed their HIV status to family members were associated with high CD4 cell count and hemoglobin level. While, hematocrit, RBC, lymphocyte count, separated marital status, widowed marital status, and substance-addicted patients were associated with low CD4 cell count and hemoglobin level. The author recommended that FMOH or other health professionals, program planners, decision makers, project implementers, government, and nongovernmental organizations should be given special attention for adult female patinets to minimize the risk of HIV progression and improve their health status. The author also recommended that health staff should conduct health-related studies for patients to examine continuous checkups. Health professionals also should give more attention to types of ART medication to reduce the progression of disease when the patients come back again into the hospital. Finally, adult female HIV-positive patients should be given special attention based on these important factors to improve their CD4 cell count, hemoglobin level, and better health quality.
艾滋病毒是21世纪全球最重要的健康问题之一,对人类社会构成严重威胁。血红蛋白水平和CD4细胞计数是艾滋病毒进展和患者生存的两个最重要的生物标志物。本研究的目的是确定在埃塞俄比亚贡德尔大学综合专科医院接受抗逆转录病毒治疗的成年女性艾滋病毒阳性患者中,与CD4细胞计数和血红蛋白水平相关的常见风险因素。
本研究的数据来源是2015年9月至2022年3月在贡德尔大学综合专科医院进行的二次数据。本研究中的数据探索采用了正态直方图、箱线图和Q-Q图,以了解与CD4细胞计数和血红蛋白水平相关的数据情况。在这个纵向数据集中使用了贝叶斯联合模型,以获取关于成年女性艾滋病毒患者的广泛信息。
女性患者的血细胞比容(%)、红细胞(10⁶/μL)、淋巴细胞(%)和体重(kg)的平均值及标准差分别为37.2(3.8)、4.0(1.6)、43.6(11.8)和44.9(9.4)。在本研究中,CD4细胞计数的随机截距模型和血红蛋白水平的随机截距和斜率模型被认为是最佳选择模型。就诊时间、血细胞比容、体重、红细胞、淋巴细胞计数、教育程度、婚姻状况、信息披露和物质使用是CD4细胞计数和血红蛋白水平的常见风险因素。
本研究得出结论,就诊时间、体重、中等教育程度者、高等教育程度者、已婚患者、向家庭成员披露其艾滋病毒状况的患者等风险因素与较高的CD4细胞计数和血红蛋白水平相关。而血细胞比容、红细胞、淋巴细胞计数、分居婚姻状况、丧偶婚姻状况和药物成瘾患者与较低的CD4细胞计数和血红蛋白水平相关。作者建议,联邦卫生部或其他卫生专业人员、项目规划者、决策者、项目实施者、政府和非政府组织应特别关注成年女性患者,以尽量降低艾滋病毒进展的风险并改善她们的健康状况。作者还建议卫生工作人员应为患者开展与健康相关的研究,以检查持续的体检情况。当患者再次入院时,卫生专业人员也应更多地关注抗逆转录病毒药物的类型,以减少疾病的进展。最后,应基于这些重要因素对成年女性艾滋病毒阳性患者给予特别关注,以提高她们的CD4细胞计数、血红蛋白水平和改善健康质量。