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首页> 外文期刊>AIDS care. >Poor retention in early care increases risk of mortality in a Brazilian HIV-infected clinical cohort
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Poor retention in early care increases risk of mortality in a Brazilian HIV-infected clinical cohort

机译：早期保险较差的保留会增加巴西艾滋病毒感染的临床队列中死亡率

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Retention in early HIV care has been associated with decreased mortality and improved viral suppression, however the consequences of poor retention in early care in Brazil remain unknown. We assessed the effect of poor retention on mortality in a Brazilian HIV-infected clinical cohort. The analysis included ART-naive, HIV-infected adults linked to care at the Instituto Nacional de Infectologia Evandro Chagas, FundacAo Oswaldo Cruz between 2000 and 2010, who did not become pregnant nor participate in a clinical trial during the first two years in care (early care). Poor retention in early care was defined as less than 3 out of 4 six-month intervals with a CD4 or HIV-1 RNA laboratory result during early care. Cox proportional hazards models were used to identify factors associated with mortality, and Kaplan-Meier plots were used to describe the survival probability for participants with poor retention versus good retention. Among 1054 participants with a median (interquartile range) follow-up time of 4.2 years (2.6, 6.3), 20% had poor retention in early care and 8% died. Poor retention in early care [adjusted hazard ratio (aHR) 3.09; 95% CI 1.65-5.79], AIDS defining illness (aHR 1.95; 95% CI 1.20-3.18) and lower education (aHR 2.33; 95% CI 1.45-3.75) were associated with increased mortality risk. Our findings highlight the importance of adopting strategies to improve retention in early HIV care.
机译：早期艾滋病毒护理的保留已与降低的死亡率有关，病毒抑制改善，但在巴西早期护理中保留不良的后果仍然未知。我们评估了巴西艾滋病毒感染的临床队列中保留不良对死亡率的影响。该分析包括艺术 - 幼稚，艾滋病毒感染的成年人，在伊霉菌植物中关注，2000年至2010年之间的基金奥斯瓦尔多克鲁斯，在2000年至2010年间，没有被怀孕，也不参加临床试验在护理期间（早期护理）。早期护理的良好保留量不足，在早期护理期间具有CD4或HIV-1 RNA实验室结果的4次六个月间隔中的少于3个。 Cox比例危险模型用于识别与死亡率相关的因素，Kaplan-Meier地块用于描述与滞留性差与良好保留相比的参与者的存活率。在1054名与中位数（四分位数范围）的参与者中，随访时间为4.2岁（2.6,6.3），20％的保留早期护理差，8％死亡。早期保健保留不佳[调整后危险比（AHR）3.09; 95％CI 1.65-5.79]，艾滋病定义疾病（AHR 1.95; 95％CI 1.20-3.18）和降低教育（AHR 2.33; 95％CI 1.45-3.75）与增加的死亡风险增加。我们的调查结果强调了采用策略改善艾滋病毒治疗早期保留的重要性。

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