2018年伊朗马什哈德HIV患者抗逆转录病毒治疗依从性及其决定因素:一项前瞻性研究

Amin Bojdy, Mahnaz Arian, M. Najafi, Mahdi Mottaghi
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引用次数: 1

摘要

适当坚持抗逆转录病毒治疗(ART)可以很好地抑制病毒载量,而坚持不良可能导致耐药菌株和治疗失败。方法:我们于2017年12月至2018年3月进行了一项前瞻性队列研究。在245名患者中,103名患者接受了抗逆转录病毒治疗。通过自我报告法和药片计数法确定患者的依从性。药片计数失败,只有依从性的自我报告被用于分析。在每次访问中,我们给每个病人一个月治疗所需的药物,并要求他们在下次访问时带回药袋。我们还询问了他们在此期间消费的片剂数量。三个月的平均依从性被认为是最终依从性。采用皮尔逊卡方模型进行分析。结果:平均年龄±SD为40±1.36岁。44.7%为女性。84.5%的患者被认为是粘附的(≥95%的剂量被消耗)。已婚患者的依从性较好(p = 0.04)。年龄、性别、成瘾、入狱史、静脉用药与依从性无关(p < 0.05)。我们还提取了治疗停止和方案改变的预览史。含有依非韦伦的方案失败率更高(p = 0.001)。结论:虽然依从性水平是可以接受的,但缺乏自我报告控制方法可能会高估依从性。
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Adherence to Antiretroviral Therapy and Its Determinants in HIV Patients in Mashhad, IRAN, 2018: a Prospective Study
Introduction:Proper adherence to antiretroviral therapy (ART) provides good viral load suppression, while poor adherence can give rise to resistant strains and failure of the treatment. Methods: We performed a prospective cohort study from December 2017 to March 2018. Of 245 patients, 103 of them were compliant with ART. Patient adherence is determined through the self-report method and pill-count method. Pill-count failed, and only self-reports of adherence were used for analysis. In each visit, we gave each patient medication needed for one month’s treatment and asked them to bring back drug-pockets in the next visit. We also ask the number of tablets they did consume in this period. Mean adherence in three months is considered final adherence. Pearson chi-square model was used for analysis.Results: Mean age ± SD was 40 ± 1.36 years. 44.7% were female. 84.5% of patients are considered adherent (≥ 95% of doses were consumed). Married patients had better adherence (p = 0.04). Age, sex, addiction, imprisonment history, intravenous drug usage were not associated with adherence (p > 0.05). We also extracted previews history of treatment cessation and regimen changes. Efavirenz containing regimens had a higher rate of failure (p = 0.001).Conclusion: Although the adherence level was acceptable, the lack of a self-report control method might overestimate adherence.
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