乌干达农村地区晚期艾滋病毒感染者死亡率相关因素:一项回顾性研究
Kabali Bwogi1, Catherine Nassozi Lwanira2, Ivan Kasamba3,4,5
1Mildmay Uganda, 12 Km Entebbe Road, Naziba Hill, Lweza, P. O. Box 24985, Kampala, Uganda. kabalibwogi@yahoo.com.
BMC infectious diseases
|August 2, 2025
概括
在乌干达,晚期艾滋病毒疾病 (AHD) 患者的死亡风险仍然存在. 诸如年龄较大,没有病毒载荷测试和缺乏结核病预防等因素显著增加了这些患者的死亡率.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 晚期诊断和延迟抗逆转录病毒疗法 (ART) 启动仍然是艾滋病毒感染者 (PLHIV) 患有晚期艾滋病毒疾病 (AHD) 的人的显著死亡风险.
- 解决这些挑战对于改善患者的治疗结果和实现全球艾滋病毒控制目标至关重要.
研究的目的:
- 在乌干达中北部农村地区,调查与艾滋病患者的PLHIV死亡率相关的因素.
- 确定可以为目标干预提供信息的关键风险因素.
主要方法:
- 乌干达18个卫生机构的电子医疗记录的回顾性审查 (2018年1月至2021年12月).
- AHD定义为基线CD4计数<200细胞/mm3.
- 考克斯的比例危险建模被用来确定与死亡率相关的因素.
主要成果:
- 对1161名患有AHD的PLHIV的分析显示,每100人年死亡率为5.4.
- 显著的死亡率预测因素包括年龄≥50岁,没有病毒载荷测试,病毒载荷不抑制,CD4计数≤50细胞/毫米3,没有结核病预防,以及世卫组织第3或第4阶段.
- 死亡率与50岁以上的年龄 (aHR 4.16),没有病毒载荷测试 (aHR 16.23),病毒载荷非抑制 (aHR 9.05),CD4 ≤50 (aHR 1.91),没有结核病预防 (aHR 3.51) 和世卫组织第三或第四阶段 (aHR 1.91) 有关.
结论:
- 尽管取得了进展,但艾滋病患者中仍然存在显著的死亡率,这凸显了艾滋病毒护理的持续挑战.
- 早期发现AHD,定期监测病毒载量,优化ART和结核病预防疗法对于降低死亡率至关重要.
- 这些干预措施对于改善患者结果和到2030年实现艾滋病毒流行病控制至关重要.
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