Brief Report: Time to Repeat Viral Load Testing Among Unsuppressed Adolescents and Young Adults Living With HIV in Kenya.
Brief Report: Time to Repeat Viral Load Testing Among Unsuppressed Adolescents and Young Adults Living With HIV in Kenya.
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DOI：
10.1097/qai.0000000000002498
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发表时间：
2020-12-15
期刊：
影响因子：
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通讯作者：
Kohler PK
中科院分区：
文献类型：
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作者：
Mugo C;Wilson KS;Onyango A;Njuguna IN;Mburu CW;Richardson BA;Oyiengo L;Inwani I;John-Stewart G;Wamalwa DC;Kohler PK
在VL未抑制后，需要重复HIV病毒载量（VL）检测，以确认治疗失败。我们评估了肯尼亚青少年和年轻人感染艾滋病毒（AYALHIV）的比例，并进行了确认性VL检测和重复检测的时间。从肯尼亚国家病毒载量数据库中提取的纵向数据的回顾性分析。2017年4月至2019年5月期间10-24岁的AYALHIV病毒载量数据来自117个HIV护理诊所。如果在抗逆转录病毒治疗（ART）开始后≥6个月进行了至少一次VL检测，则记录合格。测定了未抑制的AYALHIV（≥1000拷贝/ml）比例和首次未抑制VL与重复VL之间的时间（月）。我们提取了23，969名AYALHIV的40，928条VL记录，其中17，092人（71%）符合此分析的条件。其中，12，122例（71%）为女性，中位年龄19岁（IQR：13-23），中位ART持续时间38个月（IQR：16-76）。在合格的AYALHIV中，4，010（23%）在首次合格测量时具有未抑制的VL。只有316例（8%）未抑制的AYALHIV在3个月内重复VL，1，176例（29%）在6个月内重复VL。在2，311例病毒未抑制的AYALHIV重复VL中，首次和重复VL之间的中位时间为6个月（IQR：4-8），其中1，330例（58%）已确认治疗失败。四分之一接受ART治疗的AYALHIV患者VL未受抑制，不到三分之一的患者在6个月内接受了重复VL治疗。改善VL检测实践的策略需要改善AYALHIV的结果。
Repeat HIV viral load (VL) testing is required after unsuppressed VL to confirm treatment failure. We assessed proportion of adolescents and young adults living with HIV (AYALHIV) in Kenya with a confirmatory VL test and time to repeat testing. A retrospective analysis of longitudinal data abstracted from Kenya’s national viral load database. Viral load data for AYALHIV who were 10–24 years old between April 2017- May 2019 were abstracted from 117 HIV care clinics. Records were eligible if at least one VL test was done ≥6 months after antiretroviral treatment (ART) initiation. The proportion of unsuppressed AYALHIV (≥1000 copies/ml) and time in months between first unsuppressed VL and repeat VL was determined. We abstracted 40,928 VL records for 23,969 AYALHIV, of whom 17,092 (71%) were eligible for this analysis. Of these, 12,122 (71%) were female, median age 19 years (IQR: 13–23) and median ART duration 38 months (IQR: 16–76). Among eligible AYALHIV, 4,010 (23%) had an unsuppressed VL at first eligible measurement. Only 316 (8%) of the unsuppressed AYALHIV had a repeat VL within 3 months and 1,176 (29%) within 6 months. Among 2,311 virally unsuppressed AYALHIV with a repeat VL, median time between the first and the repeat VL was 6 months (IQR: 4–8), with 1,330 (58%) having confirmed treatment failure. One-quarter of AYALHIV on ART had unsuppressed VL, with less than a third receiving a repeat VL within 6 months. Strategies to improve VL testing practices are needed to improve AYALHIV’s outcomes.