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在阿姆哈拉地区接受二线治疗方案的艾滋病毒感染者中,病毒载量相对于CD4细胞计数在衡量生活质量方面的稳健性。

Robustness of viral load over CD4 cell count in measuring the quality of life of people with HIV at second line regimen in Amhara region.

作者信息

Tegegne Awoke Seyoum

机构信息

Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia.

出版信息

Sci Rep. 2025 Apr 28;15(1):14763. doi: 10.1038/s41598-025-93608-y.

Abstract

Access to medication for people living with HIV in need is a global health priority. Monitoring the quality of life of people under treatment helps to optimize the resource allocated for the program. Therefore, the main objective of the current study was to assess the quality of life comparing viral load and CD4 cell count and factors affecting the variable of interest among HIV-positive people under the second-line regimens. A hospital-based retrospective secondary data were used for the current investigation. The study was conducted in governmental hospitals in Amhara region. ROC curve was used for comparing CD4 cell count and viral load in assessing the quality of life and its predictors. Among the participants in second-line regimen, about 18.3% of them had CD4 cell count < 200 cells/ml of blood and 49.4% of them had detectable/unsuppressed viral load. The result of ROC curve in the current study indicates that viral load was in favors of CD4 cell count in this regard. Among the predictors for quality of life, age of patients, level of CD4 cell count while transferring to second-line regimen, sex of patients, social discrimination, level of education of patients, functional status, adherence level, disclosure status of the disease, mental depression, existence of opportunistic infections and residence area had significant effect on the variable of interest (quality of life). Viral load was in favor of CD4 cell count in assessing the quality of people under treatment. Hence, a close follow ups of patients under treatment at second-line regimen using viral load assessment is highly recommended. Due attention should be given to patients with Unsuppressed HIV viral loads. Hence, awareness creation on how the quality of life be improved should be formulated for patients during visiting times. Knowledge of HIV transmission is also important to reduce the violence and discrimination against those HIV-positive adults to improve their health status. Experience sharing between medication adherent and non-adherent patients may encourage those non-adherent patients to get lessons from adherent patients.

摘要

让有需要的艾滋病毒感染者获得药物治疗是一项全球卫生优先事项。监测接受治疗者的生活质量有助于优化该项目的资源分配。因此,本研究的主要目的是比较病毒载量和CD4细胞计数,并评估二线治疗方案下HIV阳性患者中影响相关变量的因素,以评估生活质量。本研究采用基于医院的回顾性二次数据。研究在阿姆哈拉地区的政府医院进行。受试者工作特征(ROC)曲线用于比较CD4细胞计数和病毒载量,以评估生活质量及其预测因素。在接受二线治疗方案的参与者中,约18.3%的人血液中CD4细胞计数低于200个/毫升,49.4%的人病毒载量可检测到/未得到抑制。本研究的ROC曲线结果表明,在这方面病毒载量比CD4细胞计数更具优势。在生活质量的预测因素中,患者年龄、转入二线治疗方案时的CD4细胞计数水平、患者性别、社会歧视、患者教育水平、功能状态、依从性水平、疾病披露状态、精神抑郁、机会性感染的存在以及居住地区对相关变量(生活质量)有显著影响。在评估接受治疗者的生活质量方面,病毒载量比CD4细胞计数更具优势。因此,强烈建议对接受二线治疗方案的患者使用病毒载量评估进行密切随访。应特别关注病毒载量未得到抑制的患者。因此,应在患者就诊期间制定关于如何改善生活质量的宣传措施。了解艾滋病毒传播知识对于减少对艾滋病毒阳性成年人的暴力和歧视以改善他们的健康状况也很重要。药物依从性患者和非依从性患者之间的经验分享可能会鼓励那些非依从性患者向依从性患者学习。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3672/12037734/11517741e26e/41598_2025_93608_Fig1_HTML.jpg

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