Risk Factors Associated with Unsuppressed Viral Load in HIV-1 Infected Patients at the First Antiretroviral Therapy in Morocco
Risk Factors Associated with Unsuppressed Viral Load in HIV-1 Infected Patients at the First Antiretroviral Therapy in Morocco
复制标题
DOI：
10.4103/ijmy.ijmy_41_19
复制
发表时间：
2019-04-01
影响因子：
1.2
通讯作者：
Mohammed, Boui
中科院分区：
文献类型：
--
作者：
Hicham, Titou;Ilyas, Elkassimi;Mohammed, Boui
背景：接受抗逆转录病毒治疗（ART）的 HIV 感染患者的病毒载量（VL）未受到抑制与 HIV 传播增加和生存率低相关。这项工作的目的是评估一线 ART 6 个月后与 HIV-1 感染患者 VL 未抑制（VL 400 拷贝/ml）相关的因素。方法：这是一项回顾性队列研究，研究对象为 2007 年 1 月 1 日至 2017 年 1 月 1 日期间，在拉巴特穆罕默德五世军事教学医院皮肤科和性病科接受 ART 治疗的 181 名 HIV-1 感染者。通过逻辑回归模型确定了相关因素。结果：181 名患者中，76% 为男性。纳入时，中位年龄为 35 岁。五个变量（男性、初始空腹血糖 1.1 g/l、酗酒、吸烟和初始 VL 10,000 拷贝/ml）与未抑制的 VL 显着相关（P < 0.05）。在多变量分析中，吸烟（相对风险 [RR]：4.27，95% 置信区间 [CI]：1.67-10.89）和初始 VL 10,000（RR：9.78，95% CI：2.40-39.73）与未抑制 VL 独立相关。结论：队列中大约 83% 的患者在接受 6 个月的一线 ART 后能够抑制 VL。吸烟和初始 VL 较高是未抑制 VL 的独立危险因素。这项工作强调了针对 ART 中 VL 未抑制风险患者制定和评估针对性干预措施的重要性。
Background: Nonsuppression of viral load (VL) in HIV-infected patients on antiretroviral therapy (ART) is associated with increased HIV transmission and poor survival. The objective of this work was to evaluate the factors associated with the unsuppressed VL (VL 400 copies/ml) in HIV-1-infected patients after 6 months of the first-line ART. Methods: This was a retrospective cohort study of 181 patients living with HIV-1 on ART in Dermatology and Venereology Department of Mohamed V Military Teaching Hospital of Rabat, during the period between January 1, 2007, and January 1, 2017. Associated factors were identified through a logistic regression model. Results: Of the 181 patients, 76% were men. At inclusion, the median age was 35 years. Five variables (male sex, initial fasting glucose 1.1 g/l, alcoholism, smoking, and initial VL 10,000 copies/ml) were significantly associated (P < 0.05) with unsuppressed VL. In multivariate analysis, smoking (relative risk [RR]: 4.27, 95% confidence interval [CI]: 1.67-10.89) and initial VL 10,000 (RR: 9.78, 95% CI: 2.40-39.73) were associated independently with unsuppressed VL. Conclusion: Approximately 83% of the patients in the cohort had been able to suppress VL after 6 months of the first-line ART. Smoking and high initial VL were independent risk factors of unsuppressed VL. This work highlights the importance of developing and evaluating targeted interventions for patients at risk of unsuppressed VL on ART.