Incidence Rate, Survival Rate, and Predictors for Virological Failure Among Adult TB/HIV Coinfected Clients.

IF 2.1 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Journal of Tropical Medicine Pub Date : 2025-02-15 eCollection Date: 2025-01-01 DOI:10.1155/jotm/2011556
Nurye Seid Muhie
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引用次数: 0

Abstract

Background: Tuberculosis increases human immunodeficiency virus replication and accelerates human immunodeficiency virus progression in both tuberculosis and human immunodeficiency virus coinfected patients. The objective of this study was to determine the incidence rate, survival rate, and predictors for virological failure among adult tuberculosis/human immunodeficiency virus coinfected clients. Methods: A retrospective cohort study was conducted at the University of Gondar Compressive Specialized Hospital from March 2017 to 2022. Secondary data sources were extracted based on inclusion criteria for adult tuberculosis/human immunodeficiency virus coinfected patients. The Cox proportional hazards model was used for adult tuberculosis/human immunodeficiency virus coinfected patients data. Result: The overall incidence rate of virological failure was 9.23 per 1000 person-months observations. Out of 148 coinfected patients, about 24.3% had virological failure. More than half of the patients, 52.7% and 54.1% in this study had a CD4 cell count ≥ 200/mm3 and a weight < 50 kg, respectively. Gender (hazard ratio = 1.3291, 95% CI: 1.1878-1.4873), bedridden functional status (hazard ratio = 4.7174; 95% CI: 1.2263-14.1470), WHO clinical Stage IV (hazard ratio = 1.1122, 95% CI: 1.2072-5.9693), patients with opportunistic infections (hazard ratio = 1.2849, 95% CI: 1.4289-3.8504), cotrimoxazole preventive therapy users (hazard ratio = 0.2039, 95% CI: 0.0496-0.8386), patients disclosure status (hazard ratio = 0.1609, 95% CI: 0.0279-0.9286), baseline viral load count < 1000 (hazard ratio = 0.0819, 95% CI: 0.3619-0.8447), and CD4 cell count ≥ 200 (hazard ratio = 0.2728, 95% CI: 0.0749-0.9924) were significant predictors at 5% level of confidence for time to virological failure. Conclusion: The incidence and survival rate of virological failure were high. The current study revealed that male coinfected patients, bedridden functional status, WHO clinical Stage IV, and opportunistic infections other than tuberculosis were associated with a higher time to virological failure while patients disclosed the disease to a family member, cotrimoxazole preventive therapy users, baseline viral load < 1000 copies/mL, and CD4 cell count ≥ 200/mm3 had significantly lower time to virological failure. Therefore, public health organizations should be given special attention based on these important predictors to improve their health and prolong the lives of coinfected patients.

成人结核/艾滋病合并感染患者的发病率、生存率和病毒学失败的预测因素
背景:结核病增加了人类免疫缺陷病毒的复制,加速了人类免疫缺陷病毒在结核病和人类免疫缺陷病毒共感染患者中的进展。本研究的目的是确定成人结核/人类免疫缺陷病毒合并感染患者的发病率、生存率和病毒学失败的预测因素。方法:回顾性队列研究于2017年3月至2022年在贡达尔大学压缩专科医院进行。根据成人结核/人类免疫缺陷病毒合并感染患者的纳入标准提取次要数据源。Cox比例风险模型用于成人结核/人类免疫缺陷病毒合并感染患者的数据。结果:总病毒学失败发生率为9.23 / 1000人月。148例合并感染患者中,约24.3%出现病毒学失败。超过一半的患者(52.7%和54.1%)CD4细胞计数≥200/mm3,体重< 50 kg。性别(风险比= 1.3291,95% CI: 1.1878-1.4873)、卧床功能状态(风险比= 4.7174;95%置信区间:1.2263—-14.1470)临床四期(危险比= 1.1122,95%置信区间CI: 1.2072 - -5.9693),患者机会性感染(危险比= 1.2849,95%置信区间CI: 1.4289 - -3.8504),复方磺胺甲恶唑预防治疗的用户(危险比= 0.2039,95%置信区间CI: 0.0496 - -0.8386),病人信息披露状况(危险比= 0.1609,95%置信区间CI: 0.0279 - -0.9286),基准病毒载量数量< 1000(危险比= 0.0819,95%置信区间CI: 0.3619 - -0.8447),和CD4细胞数≥200(危险比= 0.2728,95%置信区间CI:0.0749-0.9924)是病毒学失败时间的显著预测因子,置信度为5%。结论:病毒学失败发生率高,生存率高。目前的研究表明,男性共感染患者、卧床不起的功能状态、WHO临床IV期和肺结核以外的机会性感染与病毒学失败的时间相关,而向家庭成员透露疾病、复方新诺明预防治疗使用者、基线病毒载量< 1000拷贝/mL、CD4细胞计数≥200/mm3的患者的病毒学失败时间显著缩短。因此,公共卫生组织应根据这些重要的预测因素给予特别关注,以改善其健康状况,延长合并感染患者的生命。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Tropical Medicine
Journal of Tropical Medicine Immunology and Microbiology-Parasitology
CiteScore
3.90
自引率
4.50%
发文量
0
审稿时长
14 weeks
期刊介绍: Journal of Tropical Medicine is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies on all aspects of tropical diseases. Articles on the pathology, diagnosis, and treatment of tropical diseases, parasites and their hosts, epidemiology, and public health issues will be considered. Journal of Tropical Medicine aims to facilitate the communication of advances addressing global health and mortality relating to tropical diseases.
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