Who starts antiretroviral therapy in Durban, South Africa?... not everyone who should.
Who starts antiretroviral therapy in Durban, South Africa?... not everyone who should.
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DOI：
10.1097/01.aids.0000366081.91192.1c
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发表时间：
2010-01
期刊：
影响因子：
--
通讯作者：
Losina E
中科院分区：
文献类型：
--
作者：
Bassett IV;Regan S;Chetty S;Giddy J;Uhler LM;Holst H;Ross D;Katz JN;Walensky RP;Freedberg KA;Losina E
评估南非德班新的艾滋病毒诊断后12个月内开始抗逆转录病毒治疗(ART)的比率。前瞻性观察队列。成人(18岁)在两家门诊诊所进行艾滋病毒检测之前被纳入南非测试、识别和链接队列。这两个网站都提供全面的艾滋病毒护理。从医疗记录中收集艾滋病毒检测结果、CD4细胞计数、开始抗逆转录病毒治疗的日期和死亡日期，并进行为期12个月的患者/家庭访谈。抗逆转录病毒治疗合格定义为在确诊后90天内CD_4细胞计数低于200cell/μL。主要终点是符合ART资格的受试者在12个月内开始接受ART治疗。2006年11月至2008年10月，登记了1474名新诊断的艾滋病毒感染门诊患者，其中1012人(69%)在90天内接受了CD4细胞计数检测。CD_4细胞计数的中位数为159cell/μ，L(四分位数范围65~299)。在接受了CD4细胞计数检测的患者中，538人(53%)符合抗逆转录病毒治疗的条件。只有210名(39%)符合条件的参与者已知在12个月内开始接受抗逆转录病毒治疗。在符合抗逆转录病毒治疗条件的受试者中，有108例已知死亡；82%发生在抗逆转录病毒治疗开始之前或未知的抗逆转录病毒治疗状态。男性[比率比(RR)1.3，95%可信区间(CI)1.1-1.5]和没有HIV感染家人/朋友的受试者(RR 1.3，95%CI 1.1-1.7)更有可能不开始抗逆转录病毒治疗。在符合ART条件的受试者中，不到一半的人在12个月内开始接受ART。在南非德班，在开始抗逆转录病毒治疗之前，艾滋病毒确诊后出现了大量的自然减员和死亡。迫切需要为早期艾滋病毒诊断、与护理的有效联系和及时开展抗逆转录病毒治疗作出重大努力。
To evaluate rates of antiretroviral therapy (ART) initiation within 12 months of a new HIV diagnosis in Durban, South Africa. Prospective observational cohort. Adults (≥18 years) were enrolled before HIV testing at two outpatient clinics into the South African Test, Identify and Link cohort. Both sites offer comprehensive HIV care. HIV test results, CD4 cell counts, dates of ART initiation and dates of death were collected from medical records and 12-month patient/family interviews were conducted. ART eligibility was defined as a CD4 cell count less than 200 cells/μl within 90 days of HIV diagnosis. The primary endpoint was ART initiation within 12 months for ART-eligible subjects. From November 2006 to October 2008, 1474 newly diagnosed HIV-infected outpatients were enrolled, 1012 (69%) of whom underwent CD4 cell count testing within 90 days. The median CD4 cell count was 159 cells/μl (interquartile range 65–299). Of those who underwent CD4 cell count testing, 538 (53%) were ART-eligible. Only 210 (39%) eligible enrollees were known to have initiated ART within 12 months. Among ART-eligible subjects, there were 108 known deaths; 82% occurred before ART initiation or with unknown ART initiation status. Men [rate ratio (RR) 1.3, 95% confidence interval (CI) 1.1–1.5] and subjects without an HIV-infected family member/friend (RR 1.3, 95% CI 1.1–1.7) were more likely not to start ART. Less than half of ART-eligible subjects started ART within 12 months. Substantial attrition and mortality follow HIV diagnosis before ART initiation in Durban, South Africa. Major efforts directed towards earlier HIV diagnosis, effective linkage to care and timely ART initiation are urgently needed.
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影响因子：
4.4
作者：
Stirratt, Michael J.;Remien, Robert H.;Krieger, Daniel
通讯作者：
Krieger, Daniel
DOI：
10.2471/blt.07.044248
发表时间：
2008-07-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Brinkhof, Martin WG;Dabis, François;Anglaret, Xavier
通讯作者：
Anglaret, Xavier
DOI：
10.1097/qai.0b013e3181a44ef2
发表时间：
2009-06-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Bassett IV;Wang B;Chetty S;Mazibuko M;Bearnot B;Giddy J;Lu Z;Losina E;Walensky RP;Freedberg KA
通讯作者：
Freedberg KA
DOI：
10.1097/qai.0b013e31814277c8
发表时间：
2007-10-01
影响因子：
3.6
作者：
Bassett, Ingrid V.;Giddy, Janet;Walensky, Rochelle P.
通讯作者：
Walensky, Rochelle P.
影响因子：
3.8
作者：
Coetzee, D;Hildebrand, K;Goemaere, E
通讯作者：
Goemaere, E