在OPERA队列中,与艾滋病毒相关的消耗和低体重的定义,负担和预测因素
Michael B Wohlfeiler1, Rachel Palmieri Weber2, Laurence Brunet2
1AIDS Healthcare Foundation, Miami, Florida, USA.
AIDS research and human retroviruses
|July 25, 2023
概括
与艾滋病毒相关的衰竭 (HIVAW) 影响了美国12%的艾滋病毒感染者 (PWH). 年龄较大,女性性别,黑人种族,西班牙裔种族和医疗补助计划与HIVAW风险增加有关,突出显示需要提高提供者意识.
科学领域:
- 临床医学 临床医学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 与艾滋病毒相关的消耗 (HIVAW) 和低体重仍然是艾滋病毒感染者 (PWH) 的重大问题.
- 了解HIVAW的流行,发病率和预测因素对于有效的管理和改善患者治疗结果至关重要.
- 现有的数据可能无法完全捕捉到目前美国HIVAW的现状.
研究的目的:
- 确定美国艾滋病毒感染者 (PWH) 中艾滋病毒相关消耗 (HIVAW) /低体重的流行,发病率和人口统计学/临床预测因素.
- 在两个不同的时期 (2012-2015年和2016-2020年) 分析HIVAW/低体重的趋势.
- 鉴定与发生性HIVAW/低体重发展相关的因素,考虑到抗逆转录病毒疗法 (ART) 经验.
主要方法:
- 一个观察性,临床队列分析,使用从观察性药物流行病学研究和分析 (OPERA®) 队列中前性收集的电子健康记录数据.
- 在2012-2015年和2016-2020年期间在护理中的成人PWH中计算了患病率.
- 艾滋病毒AW/低体重 (以ICD码或BMI <20 kg/m2定义) 的发生率和预测因素使用回归模型进行评估,根据ART经验分层分层.
主要成果:
- 在2012-2015年和2016-2020年期间,HIVAW/低体重的周期流行率始终为12%.
- 在之前没有HIVAW/低体重的67,119名PWH中,7%的HIVAW/低体重发生事件,从HIV诊断起的中位时间为64个月.
- 预测因素包括年龄较大,女性性别,黑人种族,西班牙裔种族和医疗补助使用 (更高的几率);随着退伍军人衰老队列研究死亡指数得分的增加,观察到剂量反应关系.
结论:
- 与艾滋病毒相关的减肥/体重减轻仍然是艾滋病毒感染者的重大临床挑战,可能被医疗保健提供者低估.
- 先进的艾滋病毒感染和并发症是发生HIVAW/低体重的关键预测因素.
- 提高对HIVAW的认识和有针对性的干预措施,特别是在脆弱的PWH人群中,对于改善护理和结果至关重要.
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