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Switch to second-line ART in West African routine care: incidence and reasons for switching.

机译:转到西非常规护理的二线抗逆转录病毒疗法:发生率和切换原因。

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摘要

In sub-Saharan Africa, while antiretroviral therapy (ART) becomes widely available, access to biological measurements to monitor patients under ART remains scarce, making the management of ART difficult. We described the management of switching to second-line ART where HIV care is provided mainly in secondary health-care structures, in the region of Segou, Mali. Of 865 patients, followed under ART for a median time of 15 months, 40 switched to second-line ART (3.3 switches/100 person years). Reason for switching was failure in 18 patients (after 21 months in median) and severe intolerance in 13 (after three months in median). Switching to second-line ART occurred earlier when motivated by intolerance than by failure. The low rate of switch compares well with other studies, but was low compared to the expected rate of failure, and may indicate that physicians are reluctant to switch ART when treatment options are limited.
机译:在撒哈拉以南非洲,尽管抗逆转录病毒疗法(ART)广泛可用,但仍缺乏获得生物测量手段来监测ART病人的方法,这使得ART的管理变得困难。我们描述了在马里Segou地区转向二线抗病毒治疗的管理,在该系统中,主要在二级医疗机构中提供艾滋病毒护理。在865例患者中,接受抗逆转录病毒治疗的中位时间为15个月,其中40例转为二线抗逆转录病毒疗法(3.3开关/ 100人年)。转换的原因是18例患者的失败(中位值21个月)和13例严重不耐受(中位值3个月后)。出于不宽容而不是由失败引起的,切换到第二线ART的时间更早。较低的转换率与其他研究比较好,但与预期的失败率相比较低,这可能表明医师在治疗选择受限时不愿转换ART。

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