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埃塞俄比亚亚的斯亚贝巴三线艾滋病治疗的病毒学抑制率及其相关因素。

Virologic suppression rate and associated factors for third-line HIV treatment in Addis Ababa, Ethiopia.

机构信息

Department of Internal Medicine, Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia.

School of Medicine, Debre Tabor University, Amhara Region, Ethiopia.

出版信息

BMC Infect Dis. 2024 Sep 28;24(1):1068. doi: 10.1186/s12879-024-10002-1.

Abstract

BACKGROUND

HIV/AIDS has left a profound impact, leading to significant mortality, morbidity, economic strain, and disability on a global scale. The introduction of antiretroviral therapy (ART) has played a pivotal role in mitigating the economic burden of HIV and enhancing overall productivity. However, the emergence of virological failure presents a critical contemporary challenge within global health, reflecting the complexity of effectively managing HIV treatment outcomes in the 21st century.

METHODS

An institutional based, cross-sectional study was conducted. Data were collected using a pretested, structured checklist. Data were edited and cleaned using Microsoft Excel 2016 and analyzed using SPSS version 25. Baseline demographic and clinical data were summarized using descriptive statistics. Multiple logistic regression analysis was run to identify association between dependent and independent variables, by computing odds ratio and 95% confidence interval. A p-value < 0.05 was considered significant.

RESULTS

The study delved into the health profile of 117 individuals who were receiving treatment with a third-line antiretroviral therapy (ART) regimen. The findings revealed that the median age of the participants stood at 44 (IQR = ± 17) years and male accounted 53%. The median duration of after HIV diagnosis was found to be 14.25 (± IQR = 5.71) years. Overall virological suppression after third line ART was 76.9% at 6 months. Following adjustment with multiple variable logistic regression, good adherence to medication showed statistical significance in achieving virologic suppression (AOR = 8.48(95% CI: 2.3-30.8), p = 0.001). In contrast, the absence of a change in the second line regimen (AOR = 3.0(95% CI: 0.36-24.8), p = 0.31) and receiving second-line medication for less than three years (AOR = 1.07(95% CI: 0.39-2.95), p = 0.89), and baseline viral load above 100,000 (AOR = 1.74(0.64-2.95), p = 0.27) shows statistically non-significant association with virologic suppression.

CLINICAL TRIAL NUMBER

Not applicable.

CONCLUSION

This multicenter study provides strong evidence on virological suppression following the use of third-line antiretroviral therapy drugs in Ethiopia. The results of the study indicate rate of Virological suppression after starting third-line ART drugs is significantly linked to good adherence.

摘要

背景

艾滋病在全球范围内造成了巨大的影响,导致了大量的死亡、发病、经济压力和残疾。抗逆转录病毒疗法(ART)的引入在减轻艾滋病的经济负担和提高整体生产力方面发挥了关键作用。然而,病毒学失败的出现是全球健康领域的一个当代重大挑战,反映了在 21 世纪有效管理艾滋病治疗结果的复杂性。

方法

这是一项基于机构的横断面研究。使用经过预测试的结构化清单收集数据。使用 Microsoft Excel 2016 编辑和清理数据,并使用 SPSS 版本 25 进行分析。使用描述性统计方法总结基线人口统计学和临床数据。使用多变量逻辑回归分析计算比值比和 95%置信区间,以确定因变量和自变量之间的关联。p 值<0.05 被认为具有统计学意义。

结果

该研究深入探讨了 117 名接受三线抗逆转录病毒治疗(ART)方案治疗的患者的健康状况。研究结果显示,参与者的中位年龄为 44 岁(IQR=±17 岁),男性占 53%。HIV 诊断后中位时间为 14.25 年(IQR=±5.71 年)。三线 ART 后 6 个月的总体病毒学抑制率为 76.9%。经过多变量逻辑回归调整后,良好的药物依从性在实现病毒学抑制方面具有统计学意义(AOR=8.48(95%CI:2.3-30.8),p=0.001)。相比之下,二线方案未改变(AOR=3.0(95%CI:0.36-24.8),p=0.31)、二线药物治疗时间少于 3 年(AOR=1.07(95%CI:0.39-2.95),p=0.89)和基线病毒载量高于 100,000(AOR=1.74(0.64-2.95),p=0.27)与病毒学抑制无统计学显著关联。

临床试验编号

不适用。

结论

这项多中心研究为埃塞俄比亚使用三线抗逆转录病毒治疗药物后的病毒学抑制提供了有力证据。研究结果表明,开始使用三线 ART 药物后病毒学抑制的发生率与良好的依从性显著相关。

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The global burden of HIV.全球艾滋病负担。
Clin Dermatol. 2024 Mar-Apr;42(2):119-127. doi: 10.1016/j.clindermatol.2024.02.001. Epub 2024 Feb 21.

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