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首页> 外文期刊>AIDS care. >Effect of changing antiretroviral treatment eligibility criteria on patient load in Kampala, Uganda.
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Effect of changing antiretroviral treatment eligibility criteria on patient load in Kampala, Uganda.

机译：改变抗逆转录病毒治疗资格标准对乌干达坎帕拉患者负担的影响。

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In many resource-poor countries, CD4 count thresholds of eligibility for antiretroviral treatment (ART) were initially low (<200 cells/mm(3)) but are now being increased to improve patient survival and to reduce HIV transmission. There are few quantitative data on the effect of such increases on the demand for ART. The objective of this study was to measure HIV prevalence and the proportion of HIV-positives eligible for antiretroviral therapy at different CD4 cut-off levels among users of public health care services in Kampala, Uganda. We recruited 1200 adults from three primary care clinics in Kampala, including equal numbers of family planning (FP) clients, pregnant women, adult patients with any complaint, and persons seeking HIV counseling and testing. All participants were screened for HIV and those positive had a CD4 count done. HIV prevalence in all patients was 16.9% (203/1200). ART eligibility based on CD4 counts significantly increased from 36% at a 200 cells/mm(3) cut-off to 44% at 250 cells and to 57% at 350 cells cut-off (p for chi(2) trend<0.001). We concluded that changing cut-off levels to higher CD4 counts will significantly increase patient load in Kampala's primary care clinics, but a phased implementation should minimize negative effects on quality of care.
机译：在许多资源贫乏的国家，抗逆转录病毒治疗（ART）资格的CD4计数阈值最初很低（<200细胞/ mm（3）），但现在为了提高患者生存率和减少HIV传播而正在增加。关于这种增加对ART需求的影响的定量数据很少。这项研究的目的是在乌干达坎帕拉的公共卫生保健服务使用者中，以不同的CD4临界值测量HIV流行率和符合抗逆转录病毒治疗资格的HIV阳性比例。我们从坎帕拉的三个初级保健诊所招募了1200名成人，其中包括相等数量的计划生育（FP）客户，孕妇，有任何投诉的成年患者以及寻求HIV咨询和检测的人员。所有参与者都进行了艾滋病毒筛查，阳性者进行了CD4计数。所有患者的HIV患病率为16.9％（203/1200）。基于CD4计数的ART资格显着提高，从200细胞/ mm（3）截止时的36％增加到250细胞时的44％和350细胞时的57％（chi（2）趋势的p <0.001） 。我们得出的结论是，将截止水平更改为更高的CD4计数将大大增加坎帕拉初级保健诊所的患者负担，但分阶段实施应将对护理质量的负面影响降至最低。

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