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一个集群随机试验Visitect CD4高级疾病平台在乌干达的晚期艾滋病毒疾病的门诊患者中
Elizabeth Nalintya1, Elizabeth L Schwartz2,3, Patricia Nerima1
1Infectious Diseases Institute, Makerere University, Kampala, Uganda.
与标准CD4检测相比,Visitect CD4高级疾病平台显示了与标准CD4检测相比,先进的艾滋病毒病患者在护理中的存活率和保留率相似. 这种点诊疗试验可以以相似的成本更快地启动抗逆转录病毒疗法.
科学领域:
- 临床医学 临床医学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 先进的艾滋病毒疾病影响全球30%-40%的患者,其特点是CD4计数≤200细胞/μl.
- 访问CD4高级疾病平台是对资源有限的设置进行点诊疗测试.
- 评估CD4检测模式的临床结果对于管理先进的HIV至关重要.
研究的目的:
- 评估使用Visitect CD4平台与标准实验室CD4测试对先进的艾滋病毒病患者的生存和留在护理中的临床结果.
- 与标准护理相比,对Visitect CD4测试策略进行成本分析.
主要方法:
- 一个集群随机临床试验,涉及乌干达16家艾滋病毒诊所.
- 比较Visitect CD4测试与现场标准基于实验室的CD4测试.
- 主要结局:24周生存期和护理期间;次要:开始抗逆转录病毒治疗的时间和成本分析.
主要成果:
- 1724名参与者被录取;927人接受了Visitect CD4,797人接受了标准的CD4测试.
- 死亡或随访损失的综合终点类似:7.0% (Visitect) 与7.2% (标准) 相比.
- 开始抗逆转录病毒治疗的中位时间为Visitect的0天,而标准CD4检测的7天;Visitect的6个月平均成本较低 (US$115 vs. US$131).
结论:
- 与标准CD4检测相比,Visitect CD4检测可以更快地启动HIV治疗,相当于24周的生存期和护理中的保留期.
- 尽管具有特殊性的局限性,但Visitect CD4平台是一个成本中立的选择.
- 实施Visitect CD4测试对于在资源有限的环境中管理先进的艾滋病毒疾病是有效的.
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