开始ART的时间与南非治疗政策的变化:一个队列研究
Dorina Onoya1, Khumbo Shumba1, Caroline Mudara1
1Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Journal of acquired immune deficiency syndromes (1999)
|November 18, 2025
概括
在南非,早期的抗逆转录病毒疗法 (ART) 启动随着时间的推移而得到改善. 然而,解决晚期开始治疗和坚持治疗对于更好的艾滋病毒治疗结果至关重要.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 早期抗逆转录病毒疗法 (ART) 对艾滋病毒管理至关重要,改善了患者的治疗结果.
- 在像南非这样的高艾滋病毒负担环境中,早期ART启动的现实数据有限.
- 了解治疗启动模式对于优化艾滋病毒治疗策略至关重要.
研究的目的:
- 评估与南非早期ART启动相关的趋势和因素.
- 评估快速ART启动对保留,病毒抑制和CD4恢复的影响.
- 从高艾滋病毒负担环境中提供现实世界的证据.
主要方法:
- 使用链接的临床和实验室数据 (TIER.Net,NHLS) 的回顾性队列研究.
- 在南非四个省份,分析了2010-2017年期间进入艾滋病毒治疗的非先天性ART个人.
- 普森回归用于识别与快速ART启动 (<7天) 相关的因素.
主要成果:
- 超过120万个人进行了分析;30%的患者在诊断日启动了ART,到2017年快速启动显著增加.
- 女性性别和较低的CD4计数与更快的ART启动有关.
- 同一天的ART发起者在12个月后显示了77.6%的保留率和61.2%的病毒抑制率.
结论:
- 由于政策和医疗保健的努力,南非的ART启动加速了.
- 尽管取得了进展,但晚期护理入门和治疗坚持的挑战仍然存在.
- 需要继续努力,以确保及时启动ART,并持续坚持最佳艾滋病毒控制.
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