Immunological failure in HIV-infected adults from 2003 to 2015 in Southwest Ethiopia: a retrospective cohort study.
Immunological failure in HIV-infected adults from 2003 to 2015 in Southwest Ethiopia: a retrospective cohort study.
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DOI：
10.1136/bmjopen-2017-017413
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发表时间：
2018-08-17
期刊：
影响因子：
2.9
通讯作者：
Mwanri L
中科院分区：
文献类型：
--
作者：
Gesesew HA;Ward P;Woldemichael K;Mwanri L
评估埃塞俄比亚西南部成人艾滋病毒感染者中免疫失败（IF）的患病率、趋势和相关因素，以及抗逆转录病毒治疗（ART）转变的幅度。使用2003年6月21日至2015年3月15日在Jimma大学教学医院ART诊所的数据进行了一项回顾性队列研究。回顾性分析了2003年6月至2015年3月期间4900例艾滋病毒感染的成人患者记录。主要结局是当分化抗原4（CD 4）计数福尔斯降至基线（或以下）或ART治疗6个月后CD 4水平持续低于100个细胞/mm 3时定义的IF。分析包括描述性和推断性统计。546例（19.5%）成人发生临床失败（CF），775例（19.7%）成人发生IF，1231例（25.1%）发生CF或IF或两者兼而有之。在整个十年中，IF的患病率一直很高。年龄25至≤50岁，调整后OR（AOR 1.5，9% CI 1.2 - 2.4），女性（AOR 1.8，95% CI 1.3 - 1.9），艾滋病护理晚期就诊者（AOR 2.2，95% CI 1.6 - 2.7）且基线CD 4计数低于200个细胞/mm 3（AOR 5.5，95%CI 4.1 ~ 7.4）和诊断前无HIV检测史（AOR 0.7，95%CI 0.5 ~ 0.9）是IF的预测因素。只有29名（0.9%）感染艾滋病毒的成年人转为二线抗逆转录病毒疗法。CF或IF或两者的幅度被发现显着，并在整个日历年一贯高，虽然ART的变化被发现最小。HIV感染的成人IF患者为早期成人、女性、HIV护理的晚期就诊者、基线CD 4计数低且诊断前有HIV检测史的患者。
To assess the prevalence, trend and associated factors for immunological failure (IF), and the magnitude of antiretroviral therapy (ART) shift among adults infected with HIV in Southwest Ethiopia. A retrospective cohort study was undertaken using the data from ART clinic at Jimma University Teaching Hospital from 21 June 2003 to 15 March 2015. Retrospective analysis of 4900 HIV-infected adult patient records dating from June 2003 to March 2015 was conducted. The primary outcome was IF defined when cluster for differentiation 4 (CD4) count falls to the baseline (or below) or persistent CD4 levels below 100 cells/mm3 after 6 months of ART treatment. The analyses included descriptive and inferential statistics. 546 (19.5%) adults had developed clinical failure (CF), 775 (19.7%) adults had developed IF and 1231 (25.1%) had developed either CF or IF or both. The prevalence of IF was consistently high throughout the decade. Age 25 to ≤50 years adjusted OR (AOR 1.5, 9% CI 1.2 to 2.4), being female (AOR 1.8, 95% CI 1.3 to 1.9), late presenter for HIV care (AOR 2.2, 95% CI 1.6 to 2.7) and having baseline CD4 count below 200 cells/mm3 (AOR 5.5, 95% CI 4.1 to 7.4), and having no history of HIV testing before diagnosis (AOR 0.7, 95% CI 0.5 to 0.9) were the predictors for IF. Only 29 (0.9%) adults infected with HIV were shifted to second-line ART regimen. The magnitude of CF or IF or both was found significant and consistently high throughout the calendar year although ART shift was found minimal. HIV-infected adult patients with IF were early age adults, females, late presenters for HIV care, and those who had low baseline CD4 counts and history of HIV testing before diagnosis.
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影响因子：
2.9
作者：
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通讯作者：
Yu R
影响因子：
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作者：
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Mwanri, Lillian
DOI：
10.11604/pamj.2015.21.291.6831
发表时间：
2015
期刊：
The Pan African medical journal
影响因子：
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通讯作者：
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作者：
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