将艾滋病毒晚期疾病管理纳入常规程序设置:来自印度孟买的队列
Shrikala Acharya1, Ramesh Reddy Allam2, Vijay Kumar Karanjkar1
1Mumbai Districts AIDS Control Society, Acworth Complex, R.A. Kidwai Marg, Wadala West, Mumbai, Maharashtra, India.
在印度实施高级艾滋病毒疾病 (AHD) 管理方案是可以做到的,只要经过仔细的规划和培训. 这种综合性方法改善了艾滋病毒感染者的生存率,尽管对以前没有接受过治疗的人来说,需要密集的病例管理.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 艾滋病毒/艾滋病管理
背景情况:
- 先进的艾滋病毒疾病 (AHD) 管理方案旨在减少晚期艾滋病毒患者的发病率和死亡率.
- 印度尚未全面实施这一方案.
- 这项研究评估了将世卫组织的ADM包融入孟买常规艾滋病毒护理中的可行性.
研究的目的:
- 评估在印度的常规抗逆转录病毒疗法 (ART) 计划中实施全面的世界卫生组织高级艾滋病毒疾病 (ADM) 管理方案的可行性.
- 评估关键ADM组件的覆盖范围,包括机会性感染的查,治疗和预防.
- 记录生存结果,并确定影响AHD个体死亡率的因素.
主要方法:
- 从2020年10月到2021年12月,在孟买的17个ART中心进行了前性队列研究.
- 该ADM包包括对机会性感染的查,治疗和预防,迅速启动ART和坚持支持.
- 通过覆盖率来评估可行性,并监测了诸如快速ART启动,结核病预防治疗 (TPT),科特里莫克萨预防,TB-LAM和CrAg查等结果.
主要成果:
- 提供完整的ADM套餐给64%的确诊的有AHD的PLHIV患者.
- 观察到TPT (82%) 和科特里莫克萨预防 (99%) 的高覆盖率.
- 在12个月后,88%的患者还活着,治疗经验丰富的个体的平均存活时间明显高于未经治疗的个体.
结论:
- 在现有资源的常规程序设置中,实施完整的ADM包是可行的,前提是有仔细的规划和利益相关者的参与.
- 培训和预期规划对于成功的整合至关重要.
- 可能需要进行密集的病例管理,以进一步降低AHD未经治疗的患者的死亡率.
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