National Expansion of Antiretroviral Treatment in Thailand, 2000-2007: Program Scale-Up and Patient Outcomes
National Expansion of Antiretroviral Treatment in Thailand, 2000-2007: Program Scale-Up and Patient Outcomes
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DOI：
10.1097/qai.0b013e3181967602
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发表时间：
2009-04-15
影响因子：
3.6
通讯作者：
Pinyopornpanich, Somchai
中科院分区：
文献类型：
--
作者：
Chasombat, Sanchai;McConnell, Michelle S.;Pinyopornpanich, Somchai
目标：泰国于 2000 年开始实施国家抗逆转录病毒 (ARV) 治疗计划，所有政府医院以及一些私立医院和大学医院现在都为符合条件的艾滋病毒感染者提供治疗。我们描述了 2000 年至 2007 年期间的项目规模扩大和患者结果。 方法：本次分析纳入了来自泰国所有 76 个省份 839 家医院的数据。对 2000 年 1 月至 2005 年 12 月开始 ARV 治疗的患者的结果进行了评估。包括截至 2007 年 3 月的 Follow-Lip 数据；失访被定义为随访晚了 3 个月以上。使用 Cox 比例风险模型评估死亡风险因素； Kaplan-Meier 方法用于估计生存概率。结果：报告了 58,008 名患者的结果数据。其中，男性占52.2%；治疗开始时，中位年龄为 34 岁，中位 CD4 计数为每立方毫米 41 个细胞，50.5% 患有艾滋病。 92.4% 的患者初始治疗方案为奈韦拉平和 2 种非核苷类逆转录酶抑制剂；中位随唇时间为 1.6 年（四分位数间距 = 0.8-2.4 年）。 8.8% 的患者失访。总体 1 年生存率为 0.89（95% 置信区间 = 0.88 至 0.89）。死亡与男性、年龄 >40 岁、基线 CD4 计数显着相关
Objective: Thailand began a national antiretroviral (ARV) treatment program in 2000, and all government and some private and university hospitals now provide treatment to eligible HIV-infected patients. We describe program scale-up and patient outcomes from 2000 to 2007.Methods: Data from 839 hospitals in all 76 provinces of Thailand were included in this analysis. Outcomes were assessed for patients initiating ARV treatment from January 2000 to December 2005. Follow-Lip data through March 2007 were included; lost to follow-up was defined as >3 months late for a follow-up visit. A Cox proportional hazard model was used to assess risk factors for death; the Kaplan-Meier method was used to estimate survival probabilities.Results: Outcome data are reported for 58,008 patients. Among these, 52.2% were male; at treatment initiation, the median age was 34 years, the median CD4 count was 41 cells per cubic millimeter, and 50.5% had AIDS. The initial regimen was nevirapine and 2 nonnucleoside reverse transcriptase inhibitors for 92.4% of patients; median follow-Lip time was 1.6 years (interquartile range = 0.8-2.4 years). Lost to follow-up occurred in 8.8% of patients. Overall 1-year survival was 0.89 (95% confidence interval = 0.88 to 0.89). Death was significantly associated with male sex, age >40 years, baseline CD4 Count