Predictors of Viral Load and Medication Adherence Among HIV-Positive Adults Under Treatment at Felege-Hiwot Comprehensive Specialized Hospital, North-West, Ethiopia.

IF 1.5 Q4 INFECTIOUS DISEASES HIV AIDS-Research and Palliative Care Pub Date : 2023-01-01 DOI:10.2147/HIV.S422980
Abay Hussen Tale, Awoke Seyoum Tegegne, Denekew Bitew Belay
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Abstract

Background: Maintaining good medication adherence and decreasing viral load in patients living with HIV/AIDS are critical to ensuring antiretroviral therapy's preventive and therapeutic benefits. The main objective of this study was to assess the predictors of viral load and medication adherence among HIV-positive adults under treatment at Felege Hiwot Comprehensive Specialized Hospital (FHCSH).

Methods: A retrospective cohort study design was conducted from a random sample of 281 adult HIV-infected patients under treatment at FHCSH in northwest Ethiopia from June 2017 to June 2021. Separate GLMM was used in analysis of viral load and medication adherence, and joint mode was applied to fit those two outcomes jointly. The potential correlation of those two outcomes was linked by random intercepts. Information criteria (AIC and BIC) were used for model comparison and covariance structure selection.

Results: The small standard error of significant predictors and significant correlation between viral load and medication adherence over time provide evidence for joint model selection. The correlation between viral load and medication adherence was -0.7688 (P-value=< 0.05), which indicates that the decrement of viral load tends to increase good medication adherence. Patient substance use, visit time, baseline CD4 cell, baseline hemoglobin, and the interaction of visit time by substance use were significantly associated with viral load and medication adherence jointly.

Conclusion: The study revealed that substance user adult patients, patients with low baseline CD4 cells, and patients with low baseline hemoglobin were with high viral loads and poor medication adherence. Therefore, health officials and other concerned bodies should give special attention and high intervention to patients with low baseline hemoglobin; poor adherence and low baseline CD4 cell count.

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在埃塞俄比亚西北部的菲利格-希沃特综合专科医院接受治疗的艾滋病毒阳性成人中病毒载量和药物依从性的预测因素。
背景:维持良好的药物依从性和降低艾滋病毒/艾滋病患者的病毒载量是确保抗逆转录病毒治疗的预防和治疗效益的关键。本研究的主要目的是评估在菲利格·希沃特综合专科医院(FHCSH)接受治疗的hiv阳性成人的病毒载量和药物依从性的预测因素。方法:从2017年6月至2021年6月在埃塞俄比亚西北部FHCSH接受治疗的281名成年hiv感染者随机抽样进行回顾性队列研究设计。采用单独GLMM分析病毒载量和药物依从性,采用联合模型联合拟合这两个结果。这两种结果的潜在相关性通过随机截点联系起来。采用信息准则(AIC和BIC)进行模型比较和协方差结构选择。结果:显著预测因子的标准误差较小,病毒载量和药物依从性随时间的显著相关性为联合模型选择提供了证据。病毒载量与药物依从性的相关性为-0.7688 (p值< 0.05),表明病毒载量的降低倾向于提高良好的药物依从性。患者药物使用、就诊时间、基线CD4细胞、基线血红蛋白以及就诊时间与药物使用的相互作用与病毒载量和药物依从性共同显著相关。结论:本研究揭示成人药物使用者、低基线CD4细胞患者和低基线血红蛋白患者病毒载量高,药物依从性差。因此,卫生官员和其他有关机构应对低基线血红蛋白患者给予特别关注和高度干预;依从性差和基线CD4细胞计数低。
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CiteScore
3.00
自引率
6.70%
发文量
61
审稿时长
16 weeks
期刊介绍: About Dove Medical Press Dove Medical Press Ltd is part of Taylor & Francis Group, the Academic Publishing Division of Informa PLC. We specialize in the publication of Open Access peer-reviewed journals across the broad spectrum of science, technology and especially medicine. Dove Medical Press was founded in 2003 with the objective of combining the highest editorial standards with the ''best of breed'' new publishing technologies. We have offices in Manchester and London in the United Kingdom, representatives in Princeton, New Jersey in the United States, and our editorial offices are in Auckland, New Zealand. Dr Scott Fraser is our Medical Director based in the UK. He has been in full time clinical practice for over 20 years as well as having an active research interest.
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