Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling-What Can We Learn About Its Factors?
Failure to Attain HIV Viral Suppression After Intensified Adherence Counselling-What Can We Learn About Its Factors?
复制标题
DOI：
10.2147/idr.s393456
复制
发表时间：
2023
影响因子：
3.9
通讯作者：
中科院分区：
文献类型：
--
作者：
抗逆转录病毒疗法（ART）的引入和扩大扭转了艾滋病毒大流行的趋势，从而帮助艾滋病毒感染者实现病毒抑制。这一成功可能需要辅以强化的依从性咨询（IAC）来提高治疗的依从性。然而，尽管接受了治疗，一些PLHIV病毒载量仍然高于可接受水平。我们调查了三个月IAC治疗后抑制HIV病毒载量失败的相关因素。这项横断面研究分析了2018年1月至2019年12月期间Mwanza参加plhiv护理和治疗诊所的二手数据，这些诊所在接受抗逆转录病毒治疗至少6个月后未抑制VL。我们在接受IAC前通过病毒载量评估在一线抗逆转录病毒治疗中发现了PLHIV，并在IAC后90天进行了病毒载量评估。我们进行了描述性统计来检验病毒抑制的程度。Wilcoxon sign -rank检验用于比较IAC治疗前后的中位病毒载量，logistic回归预测与失败相关的因素。本研究包括212名受试者。干预后，大多数参与者（85.9%(182)）的依从性与基线相比有显著改善。干预后，超过半数75.5%（160人）的参与者出现病毒抑制。18-25岁的参与者（AOR = 5.6, 95% CI, 1.1-29.6）、ART开始时病人不稳定（AOR = 0.3, 95% CI, 0.13-0.62）和ART依从性差（AOR = 4, 95% CI, 1.3-12.3）仍然是IAC干预后病毒学失败的主要预测因素。尽管病毒学抑制受到抗逆转录病毒治疗依从性的影响，但本研究的结果表明，其他因素的共存有待解决。抗逆转录病毒治疗开始时的不稳定是本研究发现的一个新因素。
Introduction and expansion of antiretroviral therapy (ART) have turned the tide of HIV pandemic, thus helping people living with HIV (PLHIV) achieve viral suppression. This success may need to be complemented by intensified adherence counseling (IAC) to improve adherence to treatment. However, some PLHIV still face higher than acceptable viral loads despite being on treatment. We investigated the factors associated with the failure to suppress HIV viral load after three months of IAC sessions. This cross-sectional study analyzed secondary data from PLHIV-attended care and treatment clinics in Mwanza between January 2018 and December 2019 who had unsuppressed VL after being on ART for at least six months. We identified PLHIV in first-line ART with viral load evaluation before receiving IAC and had viral load results done at 90 days after IAC. We conducted descriptive statistics to examine the magnitude of viral suppression. Wilcoxon signed-rank test used to compare the median viral load before and after IAC sessions, and logistic regressions predicted the factors associated with failure. This study included 212 subjects. After intervention, most participants 85.9% (182) had significantly improved adherence compared to baseline. More than half 75.5% (160) of the participants had viral suppression after the intervention. Participants aged 18–25 years (AOR = 5.6, 95% CI, 1.1–29.6), unstable client during ART initiation (AOR = 0.3, 95% CI, 0.13–0.62), and poor adherence to ART (AOR = 4, 95% CI, 1.3–12.3) remained the main predictors of virological failure after IAC intervention. Even though virological suppression is influenced by ART adherence, the findings in this study have shown co-existence of other factors to be addressed. Unstable during ART initiation is a new factor identified in this study.
影响因子：
2.9
作者：
Leng X;Liang S;Ma Y;Dong Y;Kan W;Goan D;Hsi JH;Liao L;Wang J;He C;Zhang H;Xing H;Ruan Y;Shao Y
通讯作者：
Shao Y