Survival benefit from non-highly active antiretroviral therapy in a resource-constrained setting
Survival benefit from non-highly active antiretroviral therapy in a resource-constrained setting
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DOI：
10.1097/00126334-200302010-00007
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发表时间：
2003-02-01
影响因子：
3.6
通讯作者：
Sawanpanyalert, P
中科院分区：
文献类型：
--
作者：
Pathipvanich, P;Ariyoshi, K;Sawanpanyalert, P
泰国北部一家政府医院对HIV-1感染者的死亡率进行了调查，以评估抗逆转录病毒(ARV)药物治疗对死亡率的影响。从1995年10月2日至1999年10月31日在日托中心诊所就诊的所有HIV-1感染的成年患者中收集了人口统计学、临床、实验室数据和ARV药物治疗的病史。从省卫生厅的住院病历、邮寄信件和死亡证明中查明1999年10月31日前患者的生存状况。在到诊所就诊的110名患者中，我们有1081名(97%)患者的随访时间数据，总共观察了1175人年；607名患者(54.7%)死亡。临床状况、CD4组、抗逆转录病毒药物组和注册年份与死亡独立相关。单一治疗与不治疗的调整风险比为0.65(95%CI：0.48，0.87；P=.001)，双重治疗的调整风险比为0.43(95%CI：0.29，0.62；P<；.001)。泰国北部一家政府医院的病人死亡率很高。次优的ARV药物方案，如双重疗法，有很大的生存益处。人们迫不及待地期待着多种ARV药物方案的进一步成本降低。
Mortality rates among HIV-1-infected patients attending a government hospital in northern Thailand were investigated to evaluate the effect of antiretroviral (ARV) drug therapy on mortality. Demographic, clinical, and laboratory data and history of ARV drug therapy were collected from all HIV-1-infected adult patients who attended the Day Care Center clinic from October 2, 1995 through October 31, 1999. The survival status of patients until October 31, 1999 was ascertained from the hospital records, mailing letters, and death certificates at the Provincial Health Office. Of I 110 patients who attended the clinic, we had data on duration of follow-up for 1081 (97%) with a total of 1175 person-years of observation; 607 (54.7%) patients died. Clinical status, CD4 group, ARV drug group, and registered year were independently associated with death. The adjusted hazard ratio of monotherapy to no therapy was 0.65 (95% Cl: 0.48, 0.87; p =.001) and that of dual therapy was 0.43 (95% CI: 0.29, 0.62; p < .001). The mortality rate of patients attending a government hospital in northern Thailand is high. Suboptimum ARV drug regimens like dual therapy had a substantial survival benefit. Further cost reduction for multiple ARV drug regimens is impatiently awaited.