加纳阿森特曼蓬市立医院抗逆转录病毒疗法（ART）中 HIV 患者病毒载量抑制的趋势：2019-2023 年。

Trends in viral load suppression among HIV patients on antiretroviral therapy (ART) at Asante Mampong Municipal Hospital, Ghana: 2019-2023.

机构信息

School of Public Health, University of Health and Allied Sciences (UHAS), Hohoe, Volta Region, Ghana.

HIV/AIDS Prevention Research Network Cameroon, Kumba, Cameroon.

出版信息

BMC Infect Dis. 2024 Oct 16;24(1):1170. doi: 10.1186/s12879-024-10072-1.

DOI:10.1186/s12879-024-10072-1

PMID:39415134

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11483983/

Abstract

BACKGROUND

The Joint United Nations Programme on Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) (UNAIDS) aims to eradicate AIDS by 2030 through 95:95:95 targets: identifying 95% of persons living with HIV (PLHIV), initiating 95% of those identified on antiretroviral therapy (ART), and ensuring that 95% of those initiated on ART are virally suppressed. Virally suppressed patients pose minimal risk of HIV transmission. ART aims to suppress the HIV-viral load (VL) and increase immunity, reducing morbidity and mortality. This study aimed to determine the trends in VL suppression among HIV patients on ART from 2019 to 2023 at Asante Mampong Municipal Hospital.

METHODS

This study adopted a retrospective Hospital-based design in which secondary data from 842 patients on ART from 2019 to 2023 were used. The study design specifically involved conducting serial cross-sectional studies to measure the prevalence of VL suppression each year from 2019 to 2023. This approach allowed the researchers to analyse the annual prevalence of VL suppression among study participants without following individual participants longitudinally throughout the entire period. The data were analysed via STATA version 17.0. Chi-square and logistic regressions were used to determine the associations between VL suppression and the independent variables at p < 0.05 and 95% confidence intervals (CIs).

RESULTS

In 2019, VL suppression was 79.6%, decreasing to 40.0% in 2020 and then rising to 82.7% in 2021, dropping to 67.8% in 2022 and 66.7% in the first quarter of 2023. Clients aged 40-49, 50-59, and 60-69 years were more likely to have VL suppression [aOR = 4.4 (1.36-14.25), p = 0.013], [aOR = 5.5 (1.65-18.39), p = 0.006] and [aOR = 5.0 (1.42-17.46), p = 0.012], respectively. Clients who were consistently on the same type of ART for more than a year were more likely to have VL suppression [aOR = 10.6 (4.18-26.76), p < 0.001].

CONCLUSION

VL suppression was low among patients. Advanced age and being on the same ART for more than 12 months were significantly associated with VL suppression. Health promotion activities are needed for people who have been suppressed to maintain and achieve a lifetime undetectable VL, targeting the younger age group.

摘要

背景

联合国艾滋病毒/艾滋病联合规划署（UNAIDS）的目标是到 2030 年通过 95:95:95 目标消灭艾滋病：发现 95%的艾滋病毒感染者（PLHIV），对 95%已发现的感染者启动抗逆转录病毒治疗（ART），并确保 95%已启动 ART 的感染者病毒得到抑制。病毒得到抑制的患者传播艾滋病毒的风险极小。ART 的目的是抑制艾滋病毒载量（VL）并增强免疫力，降低发病率和死亡率。本研究旨在确定 2019 年至 2023 年期间在阿桑特·曼蓬市立医院接受 ART 的艾滋病毒患者的 VL 抑制趋势。

方法

本研究采用回顾性基于医院的设计，使用了 2019 年至 2023 年期间接受 ART 的 842 名患者的二次数据。该研究设计特别涉及进行连续的横断面研究，以衡量 2019 年至 2023 年每年的 VL 抑制率。这种方法允许研究人员在不跟踪整个时期内所有个体参与者的情况下，分析研究参与者中每年 VL 抑制的患病率。数据通过 STATA 版本 17.0 进行分析。卡方检验和逻辑回归用于确定 VL 抑制与独立变量之间的关联，置信区间（CI）为 p<0.05 和 95%。

结果

2019 年，VL 抑制率为 79.6%，2020 年降至 40.0%，2021 年上升至 82.7%，2022 年降至 67.8%，2023 年第一季度降至 66.7%。40-49 岁、50-59 岁和 60-69 岁的客户更有可能实现 VL 抑制[aOR=4.4（1.36-14.25），p=0.013]，[aOR=5.5（1.65-18.39），p=0.006]和[aOR=5.0（1.42-17.46），p=0.012]。持续使用同一种 ART 超过一年的患者更有可能实现 VL 抑制[aOR=10.6（4.18-26.76），p<0.001]。