Outcomes of Nigeria's HIV/AIDS Treatment Program for Patients Initiated on Antiretroviral Treatment between 2004-2012
Outcomes of Nigeria's HIV/AIDS Treatment Program for Patients Initiated on Antiretroviral Treatment between 2004-2012
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DOI：
10.1371/journal.pone.0165528
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发表时间：
2016-11-09
期刊：
影响因子：
3.7
通讯作者：
Ellerbrock, Tedd V.
中科院分区：
文献类型：
--
作者：
Dalhatu, Ibrahim;Onotu, Dennis;Ellerbrock, Tedd V.
背景尼日利亚抗逆转录病毒疗法（ART）项目始于2004年，目前是非洲最大的项目之一。然而，全国代表性的数据结果还没有reported.Methods我们评估了回顾性队列数据，从一个全国代表性的样本，年龄≥ 15岁的成年人开始ART在2004年至2012年。数据是从3，496例患者记录中提取的，这些患者记录来自35个使用概率与大小成比例（PPS）抽样的研究中心。分析是加权和控制复杂的调查设计。主要结局指标为死亡率、失访（LTFU）和保留率（存活和接受ART的比例）。结果在ART启动时，66.4%（%）为女性，中位年龄为33岁，中位体重为56 kg，中位CD 4计数为161个细胞/mm 3，47.1%为III/IV期疾病。12、24、36和48个月时保留的患者百分比分别为81.2%、74.4%、67.2%和61.7%。在超过10，088人-年的ART治疗中，死亡率、LTFU和总损耗率（死亡率、LTFU和治疗停止）分别为1.1（95%置信区间（CI）：0.7-1.8）、12.3（95% CI：8.9-17.0）和13.9（95% CI：10.4-18.5）/100人-年（py）。ART治疗前3个月的脱落率最高，为55.4/100 py。LTFU的预测因素包括：中学以下教育水平（参考：大专）、东北和南南地区的护理（参考：中北部）、中度/重度贫血、症状性功能状态和基线体重
Background The Nigerian Antiretroviral therapy (ART) program started in 2004 and now ranks among the largest in Africa. However, nationally representative data on outcomes have not been reported.Methods We evaluated retrospective cohort data from a nationally representative sample of adults aged >= 15 years who initiated ART during 2004 to 2012. Data were abstracted from 3,496 patient records at 35 sites selected using probability-proportional-to-size (PPS) sampling. Analyses were weighted and controlled for the complex survey design. The main outcome measures were mortality, loss to follow-up (LTFU), and retention (the proportion alive and on ART). Potential predictors of attrition were assessed using competing risk regression models.Results At ART initiation, 66.4 percent (%) were females, median age was 33 years, median weight 56 kg, median CD4 count 161 cells/mm(3), and 47.1% had stage III/IV disease. The percentage of patients retained at 12, 24, 36 and 48 months was 81.2%, 74.4%, 67.2%, and 61.7%, respectively. Over 10,088 person-years of ART, mortality, LTFU, and overall attrition (mortality, LTFU, and treatment stop) rates were 1.1 (95% confidence interval (CI): 0.7-1.8), 12.3 (95% CI: 8.9-17.0), and 13.9 (95% CI: 10.4-18.5) per 100 person-years (py) respectively. Highest attrition rates of 55.4/100py were witnessed in the first 3 months on ART. Predictors of LTFU included: lower-than-secondary level education (reference: Tertiary), care in North-East and South-South regions (reference: North-Central), presence of moderate/severe anemia, symptomatic functional status, and baseline weight