Trends in Retention on Antiretroviral Therapy in National Programs in Low-Income and Middle-Income Countries
Trends in Retention on Antiretroviral Therapy in National Programs in Low-Income and Middle-Income Countries
复制标题
DOI：
10.1097/qai.0b013e3181d73e1b
复制
发表时间：
2010-08-01
影响因子：
3.6
通讯作者：
Souteyrand, Yves
中科院分区：
文献类型：
--
作者：
Tassie, Jean-Michel;Baijal, Parijat;Souteyrand, Yves
目的：记录低收入和中等收入国家在开始治疗后12-48个月继续接受抗逆转录病毒治疗（ART）的患者的区域和全球趋势。方法：汇总2008年国家规划向世卫组织/联合国儿童基金会/联合国艾滋病规划署报告的数据，得出区域和全球估计数。在12、24、36和48个月接受抗逆转录病毒治疗的患者比例来自抗逆转录病毒药物配药机构的队列监测系统。结果：在149个国家中，70个（47%）报告了12个月的保留率，54个（36%）报告了24个月的保留率，38个（26%）报告了36个月的保留率，30个（20%）报告了48个月的保留率。区域和全球趋势表明，抗逆转录病毒治疗项目的大部分人员流失发生在第一年，此后下降。撒哈拉以南非洲国家在12个月时抗逆转录病毒治疗的保留率估计为75.2%，在24个月时为66.8%，并在48个月时保持类似水平。结论：经过第一年的高流失率后，抗逆转录病毒治疗的保留率趋于稳定。在文献中，第一年的磨损与早期死亡有关。早期诊断艾滋病毒感染、及时筛查和获得抗逆转录病毒治疗对减少艾滋病毒感染至关重要。各国在报告抗逆转录病毒治疗成果方面需要得到支持。
Objectives: To document regional and global trends for patients retained on antiretroviral therapy (ART) 12-48 months after treatment initiation, in low-income and middle-income countries.Methods: Data reported by national programs to WHO/UNICEF/UNAIDS in 2008 were aggregated to produce regional and global estimates. The proportion of patients on ART at 12, 24, 36, and 48 months is derived from cohort monitoring systems in ART dispensing facilities.Results: Of 149 countries, 70 (47%) reported on retention at 12 months, 54 (36%) at 24 months, 38 (26%) at 36 months, and 30 (20%) at 48 months. Regional and global trends showed that the majority of attrition from ART programs occurred within the first year and declined thereafter. Among countries in sub-Saharan Africa, retention on ART was estimated at 75.2% at 12 months, 66.8% at 24 months, and remained at a similar level up to 48 months.Conclusions: After high attrition in the first year, retention on ART tends to stabilize. In the literature, attrition in the first year was related to early mortality. Earlier presentation for diagnosis of HIV infection, timely screening, and access to ART are fundamental to reduce it. Countries need support in reporting on outcomes on ART.