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首页> 外文期刊>AIDS care. >Nonadherence to medical appointments is associated with increased plasma HIV RNA and decreased CD4 cell counts in a community-based HIV primary care clinic.
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Nonadherence to medical appointments is associated with increased plasma HIV RNA and decreased CD4 cell counts in a community-based HIV primary care clinic.

机译：在基于社区的HIV初级保健诊所中，不依从医疗任命会导致血浆HIV RNA增加和CD4细胞计数减少。

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摘要

This study examined the association of appointment nonadherence to markers of disease severity using one year of demographic and health information on 995 individuals with HIV in primary care at an urban community health centre. At the latest visit, 106 of 946 valid cases (11.2%) had a CD4 less than or equal to 200, and 454 of 936 valid cases (48.5%) had detectable plasma HIV RNA (greater than 50 copies/ml). Using logistic regression, appointment nonadherence (number of missed appointments) was a significant predictor (p<.03) of having an AIDS-defining CD4 count over and above the effects of number of kept appointments (p<.0001), and whether or not the patient was taking HAART (p<.002). Appointment nonadherence was also a significant predictor (p<.05) of having a detectable viral load over and above the effects of number of kept appointments (p<.003), HAART (p<.0001) and age (p<.004). Looking only at individuals with a detectable viral load at the earliest visit, the only significant unique predictor of improvement to an undetectable viral load at the latest visit was being on HAART (p<.05). Looking at those only with an undetectable viral load at the earliest visit, the only predictor of declining to a detectable viral load was number of kept appointments (p < 003), and being on HAART (p<.05).
机译：这项研究使用了一年的人口统计和健康信息，对城市社区卫生中心的995名艾滋病毒感染者进行了调查，从而研究了约会不依从性与疾病严重程度标记之间的关系。在最近的访问中，946例有效病例中有106例（11.2％）的CD4小于或等于200，而936例有效病例中有454例（48.5％）的血浆HIV RNA（大于50拷贝/ ml）。使用逻辑回归，约会不坚持（错过约会的次数）是具有AIDS定义的CD4计数超过保留约会次数的影响（p <.0001）的重要预测因子（p <.0001），以及是否并非患者正在服用HAART（p <.002）。预约不坚持也是重要的预测指标（p <.05），具有超过可保留约会次数（p <.003），HAART（p <.0001）和年龄（p <.004）影响的可检测病毒载量）。仅查看最早访问时具有可检测病毒载量的个体，最后一次访问中唯一可预测的改善未检测到病毒载量的重要预测因子是HAART（p <.05）。观察那些最早访问时只有病毒载量无法检测的人，唯一可预测的病毒载量下降的预测指标是预约的人数（p <003），并且处于HAART（p <.05）。

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