埃塞俄比亚贡达尔大学综合专科医院15岁以下人类免疫缺陷病毒感染儿童开始抗逆转录病毒治疗后的生存时间

Asrat Atsedeweyn Andargie, Yemane Asmleash
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引用次数: 9

摘要

人体免疫缺陷病毒(艾滋病毒)已成为撒哈拉以南非洲儿童死亡和发病的主要原因之一。但是,迄今为止,在提供抗逆转录病毒治疗方面对感染艾滋病毒儿童的关注排在第二位。这项研究的目的是确定对在埃塞俄比亚贡达尔贡达尔大学综合专科医院接受抗逆转录病毒治疗护理的艾滋病毒感染儿童的生存状况有重大影响的预测因素。该研究中使用的数据基于2008年至2013年期间在埃塞俄比亚贡达尔大学综合专科医院开始抗逆转录病毒治疗并随访至2015年4月的15岁以下艾滋病毒感染儿童的医院记录的二次数据。采用多变量Cox比例模型拟合确定影响ART治疗后儿童生存率的因素。中位生存期为55个月。随访结束时,46例(17.1%)患儿死于该病,其余223例(82.9%)患儿存活,但未随访。Cox回归模型多因素分析显示,1例患者年龄(年龄< 1.5岁HR: 3.590;95% ci: 1.439, 8.953;P = 0.006,基线血红蛋白水平(血红蛋白水平< 7g/dl HR: 6.286;95% ci: 2.328, 16.973;P=0.000, WHO临床分期(III期HR: 0.308;95% ci: 0.150, 0.630;P = 0.001);基线CD4计数(HR: 0.180;95% ci: 0.084, 0.388;P = 0.000)是影响感染艾滋病毒儿童在92个月随访期间存活的重要因素。因此,应特别注意接受抗逆转录病毒治疗的幼儿;CD4细胞计数低的患者,世卫组织晚期临床分期(III期和IV期)患者;以及血红蛋白水平低的患者,以提高接受抗逆转录病毒治疗的艾滋病毒感染儿童的存活率。关键词:儿童,抗逆转录病毒治疗,艾滋病毒,生存,埃塞俄比亚
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Survival time of human immunodeficiency virus (HIV) infected children under 15 years of age after initiation of antiretroviral therapy in the University of Gondar Comprehensive Specialized Hospital, Ethiopia
Human immunodeficiency virus (HIV) has emerged as one of the leading causes of childhood mortality and morbidity in sub Saharan Africa. But, the attention given to HIV-infected children in terms of providing antiretroviral treatment (ART) had so far been ranked second. The study had the objectives of identifying predictors that had significant impacts on the survival status of HIV infected children who received antiretroviral treatment care in the University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The data used in the study was based on secondary data from hospital records of HIV infected children aged below 15 years who started ART between 2008 and 2013 and who followed through April 2015 in University of Gondar Comprehensive Specialized Hospital, Gondar, Ethiopia. The Multivariable Cox Proportional model was fitted to identify factors affecting the survival of children after initiation of ART. The median survival time frame was found to be 55 months. At the end of the follow up, 46 (17.1%) children died due to the disease, the remaining 223 (82.9%) were alive and lost to follow-up. The multivariate analysis of the Cox Regression model showed that the age of a patients (for age < 1.5 years HR: 3.590 ; 95% CI: 1.439, 8.953; P = 0.006, baseline hemoglobin level (for hemoglobin level < 7g/dl HR: 6.286; 95% CI: 2.328, 16.973; P=0.000, WHO clinical stage (For stage III HR: 0.308 ; 95% CI: 0.150, 0.630; P = 0.001); and baseline CD4 count(HR: 0.180 ; 95% CI: 0.084, 0.388; P = 0.000) are significant factors of survival of HIV infected children during the 92 months of follow up. Therefore, special attention should be given to younger children in ART; patients with low CD4 cell count, patients with advanced WHO clinical staging (stage III and IV); and patients with low hemoglobin level to improve the survival of HIV infected children treated with ART.    Key words: Children, antiretroviral therapy (ART), HIV, survival, Ethiopia.
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