Assessment of the magnitude and associated factors of immunological failure among adult and adolescent HIV-infected patients in St. Luke and Tulubolo Hospital, Oromia Region, Ethiopia.
Assessment of the magnitude and associated factors of immunological failure among adult and adolescent HIV-infected patients in St. Luke and Tulubolo Hospital, Oromia Region, Ethiopia.
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DOI：
10.11604/pamj.2015.21.291.6831
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Kumie A
中科院分区：
文献类型：
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作者：
Bayou B;Sisay A;Kumie A
使用抗逆转录病毒疗法 (ART) 已成为治疗 HIV 感染的标准治疗方法。然而，成本和抗逆转录病毒治疗是获得治疗的主要障碍，特别是在资源有限的环境中。在这项研究中，我们旨在评估埃塞俄比亚奥罗米亚地区圣卢克和图卢博洛医院接受高效抗逆转录病毒治疗 (HAART) 的成人和青少年 HIV 感染患者（15 岁以下）免疫失败的程度和相关因素。在埃塞俄比亚奥罗米亚州西南绍阿区的圣卢克医院和图鲁博洛医院开始接受第一线抗逆转录病毒治疗的艾滋病毒感染者中进行了一项回顾性随访研究。总共审查了 828 份患者病历。女性 477 人（57.6%），中位年龄 32 岁。中位基线 CD4 计数为 148 个细胞/mm3。最常见的 ART 处方是基于 TDF 的 (36.7%)。在审查的 828 名患者中，6.8%（56 名）出现了免疫功能衰竭。其中只有 20 例 (2.4%) 被发现并接受二线治疗。免疫失败的发生率为每100人年随访1.8例。与那些公开自己的 HIV 状况的患者相比，未向任何人透露其 HIV 状况的患者免疫失败的风险较高（AHR，0.429；95% CI 0.206 - 0.893；P 值=0.024）。未披露艾滋病毒状况和动态基线功能状态被发现是免疫失败的预测因素。大多数免疫失败病例没有及早发现，也没有转为二线ARV方案。因此存在上述危险因素的患者应考虑及时转用二线HAART。
The use of antiretroviral therapy (ART) has become a standard of care for the treatment of HIV infection. However, cost and resistance to ART are major obstacles for access to treatment especially in resource-limited settings. In this study, we aimed to assess the magnitude and associated factors of Immunological failure among adult and adolescent HIV infected Patients (with age ‘15yrs) on Highly Active Antiretroviral Therapy (HAART) in St. Luke and Tulu Bolo Hospitals, Oromia Region, Ethiopia. A retrospective follow-up study was conducted among HIV-infected patients initiated 1st line ART at St. Luke and Tulu Bolo Hospitals, South West Shoa Zone, Oromia, Ethiopia. A total of 828 patient charts were reviewed. 477(57.6%) were female and the median age was 32 years. The median baseline CD4 count was 148cells/mm3. The most common prescribed ART was TDF based (36.7%). Out of 828 patients chart reviewed 6.8% (56) were developed immunological failure. Out of them only 20 (2.4%) were detected and put on second line regimen. The incidence of immunological failure was 1.8 cases per 100 person years of follow-up. Patients who had not disclosed their HIV status to any one had high risk of immunological failure compared with patients those who had disclosed their HIV status (AHR, 0.429; 95% CI 0.206 - 0.893; P-value=0.024). Non disclosures of HIV status and with ambulatory of baseline functional status were found to be predictors of immunological failure. Most of the immunological failure cases were not detected early and not switched to second line ARV regimen. So patients with the above risk factors should be considered for a timely switch to second line HAART.