多州马尔科夫模型对艾滋病毒/艾滋病患者的治疗时间变化:回顾性队列国家数据集,埃塞俄比亚
Tsegaye Hailu Kumsa1,2, Andargachew Mulu3, Joseph Beyene4
1Department of Statistics, Hawassa University, Hawassa, Ethiopia. tsegaye.hailu@ahri.gov.et.
BMC infectious diseases
|June 24, 2024
概括
许多接受抗逆转录病毒治疗 (ART) 的患者因药物毒性,并发症或药物不可用而改变治疗方案. 机会性疾病和低CD4计数等因素增加了艾滋病毒患者治疗调整的风险.
科学领域:
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
- 公共卫生 公共卫生
背景情况:
- 抗逆转录病毒疗法 (ART) 的挑战包括病毒学失败,耐药性和毒性,需要修改治疗.
- 这些问题阻碍了ART的长期可持续性,影响了患者管理.
- 了解影响一线ART治疗方案变化的因素对于优化艾滋病毒治疗至关重要.
研究的目的:
- 评估一线抗逆转录病毒疗法 (ART) 的持久性.
- 确定导致患者高活性抗逆转录病毒疗法 (HAART) 方案变化的因素.
- 分析ART治疗修改的原因和预测因素.
主要方法:
- 从2019年10月到2020年3月进行了一项回顾性队列研究.
- 用多阶段的集群采样来选择ART设施和患者记录.
- 采用多状态生存模型 (MSM) 来估计过渡概率,并确定与治疗变化相关的因素.
主要成果:
- 14.4%的患者在随访期间至少一次改变了他们的ART治疗方案.
- 改变治疗的主要原因包括毒性/并发症 (38.6%),药物不可用 (18.3%),以及其他因素 (43.1%).
- 特定的HAART组合 (TDF+3TC+NVP,d4T+3TC+NVP,TDF+3TC+EFV) 与更高的改变率有关;机会性疾病,低体重,基线CD4计数和结核病阳性是危险因素.
结论:
- 该研究提供了使用国家数据对ART药物状况和管理的基础.
- 患者经常因药物毒性,并发症或无法使用而调整治疗.
- 基线结核病阳性,低CD4计数,机会性疾病和低体重是ART治疗调整的重要风险因素.
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