科勒布教学医院HIV抗逆转录病毒治疗患者的高血压及其相关因素

E. Nartey, R. Tetteh, F. Anto, B. Sarfo, W. Kudzi, R. Adanu
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引用次数: 0

摘要

背景:HIV感染的慢性性质需要终身抗逆转录病毒治疗(ART)来持续抑制HIV病毒复制,降低发病率和死亡率。合并症的管理是与用于艾滋病毒治疗的多药物方案相关的主要挑战之一。高血压作为艾滋病毒感染者(PLHIV)的合并症已成为一项重要的公共卫生挑战,并对艾滋病毒诊所的患者管理和服务提供产生重要影响。本研究确定了在Korle-bu教学医院(KBTH) HIV门诊就诊的患者中高血压的患病率,并探讨了HIV/ART与高血压之间关系的本质,以帮助确定可以从干预措施中获益的个体,以预防或延迟高血压并发症的发生,从而提高HIV感染者的整体生活质量。采用简单的随机抽样技术,在常规门诊就诊样本框架的基础上招募研究参与者。采用世卫组织逐步监测慢性病危险因素方法编制的问卷进行了修改,并用于收集研究参与者的数据。估计了研究参与者中高血压的患病率。采用有目的的协变量选择方法,通过logistic回归模型确定与高血压相关的社会人口统计学、生活方式、人体测量学、代谢和HIV/ art相关因素。结果:共招募了311名PLHIV患者作为研究参与者。本研究显示,在KBTH HIV门诊就诊的患者中高血压患病率为36.7%,与高血压相关的因素为年龄增加、高血压家族史阳性、运动量最小、当前BMI≥25.0 kg/m2、总胆固醇水平≥5.17 mmol/L、接受抗逆转录病毒治疗和接受抗逆转录病毒治疗时间延长。结论:本研究表明,在KBTH HIV门诊就诊的患者中,高血压患病率较高,这与抗逆转录病毒治疗暴露和暴露时间延长有关。血压监测应从艾滋病毒诊所的常规监测转变为对高血压患者进行更有目的的筛查。应该鼓励患者在家里定期测量血压,而不仅仅是在他们去HIV诊所的时候。
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Hypertension and Associated Factors among Patients on HIV Antiretroviral Therapy at Korle-Bu Teaching Hospital
Background: The chronic nature of HIV infection requires lifelong Antiretroviral Therapy (ART) to continuously suppress HIV viral replication, reducing morbidity and mortality. Management of co-morbidities is one of the major challenges associated with the multi-drug regimens used for HIV therapy. Hypertension as a co-morbidity in Persons Living with HIV (PLHIV) has become an important public health challenge and importantly influence patient management and service delivery at HIV clinics. This study determined the prevalence of hypertension among patients attending HIV clinic at the Korle-bu Teaching Hospital (KBTH) and also explored the nature of the relationship between HIV/ART and hypertension in order to help identify individuals who could benefit from interventions to prevent or delay the onset of complications of hypertension and thereby improve the overall quality of life of PLHIV Methods: A simple random sampling technique was used to recruit study participants based on the routine clinic attendance sample frame. A questionnaire adapted from WHO STEPwise approach to chronic disease risk-factor surveillance was modified and used for the collection of study participants' data. The prevalence of hypertension was estimated among study participants. Socio-demographic, lifestyle, anthropometric, metabolic and HIV/ART-related factors associated with hypertension were determined by logistic regression modelling using the purposeful selection of covariates method. Results: A total of 311 PLHIV were recruited as study participants. The present study revealed that the prevalence of hypertension in patients attending HIV clinic at KBTH was 36.7% and the factors associated with hypertension were increasing age, positive family history of hypertension, minimal exercising, current BMI ≥25.0 kg/m2, total cholesterol level ≥5.17 mmol/L, exposure to ART and increasing duration of ART exposure. Conclusion: This study shows a high prevalence of hypertension among patients attending HIV clinic at KBTH which is associated with exposure to Antiretroviral Therapy and increasing duration of this exposure. Blood pressure monitoring should move from being routine at the HIV clinic to more purposeful screening of patients for hypertension. Patients should be encouraged to have regular blood pressure measurements at home and not only when they visit HIV clinic.
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