Impact of malnutrition and social determinants on survival of HIV-infected adults starting antiretroviral therapy in resource-limited settings
Impact of malnutrition and social determinants on survival of HIV-infected adults starting antiretroviral therapy in resource-limited settings
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DOI：
10.1097/qad.0b013e328353f363
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发表时间：
2012-06-01
期刊：
影响因子：
3.8
通讯作者：
Lefebvre, Nicolas
中科院分区：
文献类型：
--
作者：
Argemi, Xavier;Dara, Som;Lefebvre, Nicolas
目的：确定营养不良，贫血和社会因素对生存的影响，一旦开始抗逆转录病毒治疗（ART）在一个队列的艾滋病毒感染的成年人在农村艾滋病毒护理中心在西哈努克，Cambodia.Methods：回顾性和描述性队列研究的成年人开始抗逆转录病毒治疗2004年12月至2009年7月。我们使用Kaplan-Meier和考克斯回归生存分析，以确定死亡的预测因素。结果：在1002例患者中，49.7%是男性，中位年龄为40岁，随访中位时间为2.4年，10.4%在随访期间死亡。基线时，中位CD 4细胞计数为83个细胞/μ l，79.9%处于WHO III或IV期。在多因素分析中，营养不良似乎是一个强大的和独立的死亡危险因素; 11.2%的BMI小于16 kg/m2，风险比为6.97 [95%置信区间（CI），3.51-13.89]，21.5%的BMI在16 - 18 kg/m2之间，风险比为2.88（95% CI，1.42-5.82），30.8%的BMI在18 - 20 kg/m2之间，风险比为2.18（95% CI，1.09-4.36）。严重贫血（血红蛋白
Objectives: Determining the impact of malnutrition, anaemia and social determinants on survival once starting antiretroviral therapy (ART) in a cohort of HIV-infected adults in a rural HIV care centre in Sihanoukville, Cambodia.Methods: Retrospective and descriptive cohort study of adults starting ART between December 2004 and July 2009. We used the Kaplan-Meier and Cox regression survival analyses to identify predictors of death.Results: Out of 1002 patients, 49.7% were men; median age was 40; median time of follow-up was 2.4 years and 10.4% died during the follow-up. At baseline, median CD4 cell count was 83 cells/mu l, 79.9% were at WHO stage III or IV. In multivariate analysis, malnutrition appeared to be a strong and independent risk factor of death; 11.2% had a BMI less than 16 kg/m(2) and hazard ratio was 6.97 [95% confidence interval (CI), 3.51-13.89], 21.5% had a BMI between 16 and 18 kg/m(2) and hazard ratio was 2.88 (95% CI, 1.42-5.82), 30.8% had a BMI between 18 and 20 kg/m(2) and hazard ratio was 2.18 (95% CI, 1.09-4.36). Severe anaemia (haemoglobin