超越病毒载量:揭示马尼卡兰省,津巴布韦的非传染性疾病模式
Kudzai F V Chokuona1, Munyaradzi Mukuzunga2, Tsitsi P Juru1
1Department of Primary Health Care Sciences, Faculty of Family Medicine, Global and Public Health Unit, University of Zimbabwe, Harare, Zimbabwe.
Journal of public health in Africa
|June 5, 2025
概括
高血压和糖尿病等非传染性疾病在艾滋病毒感染者中很常见. 长期使用ART和年龄增加风险,但基于efavirenz的疗法可以提供对高血压的保护.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 心脏病学 心脏病学
背景情况:
- 非传染性疾病 (NCD) 是艾滋病毒感染者 (PLHIV) 死亡的新兴和主要原因.
- 了解PLHIV的NCD趋势和结果对于有效的管理和改善生存率至关重要.
研究的目的:
- 在PLHIV中确定五种优先非传染性疾病 (高血压,糖尿病,慢性脏病,癌症,慢性呼吸道疾病) 的疾病趋势,患病率和结果.
- 在艾滋病毒感染和抗逆转录病毒疗法 (ART) 的背景下分析与非传染性疾病发展相关的风险因素.
主要方法:
- 马尼卡兰省974名患者病历的回顾性审查 (2013年10月 - 2023年9月).
- 对五种优先非传染性疾病的分析:高血压 (HPT),糖尿病 (DM),慢性损伤 (CKD),癌症和慢性呼吸系统疾病 (CRC).
- 使用卡普兰-梅尔和考克斯的比例危险分析来确定风险和危险比率.
主要成果:
- 高血压 (9.7%) 和糖尿病 (7.8%) 是PLHIV中最常见的非传染性疾病.
- 增加年龄和ART的持续时间 (>5年) 被确定为DM和HPT的危险因素.
- 基于蛋白酶抑制剂的ART疗法与DM风险增加有关 (HR=4.66),而基于efavirenz的疗法显示出对HPT的保护作用 (HR=0.47).
结论:
- 高血压和DM是PLHIV中显著的并发症,患病率随着年龄和ART持续时间的增加而增加.
- 个性化ART治疗方案,如使用基于efavirenz的治疗,可以减轻HPT的风险.
- 建议定期进行NCD查,对健康生活方式的患者教育,以及综合的HIV/NCD护理模式.
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