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首页> 外文期刊>AIDS Research and Human Retroviruses >The impact of retention in early HIV medical care on viro-immunological parameters and survival: a statewide study.
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The impact of retention in early HIV medical care on viro-immunological parameters and survival: a statewide study.

机译：保留早期艾滋病毒医疗对病毒免疫学参数和存活的影响：一项全州研究。

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Current literature on retention in HIV care fails to account for patients who continually/simultaneously access different providers. This statewide study examined retention in early HIV medical care and its impact on viro-immunological improvement and survival outcomes. It was a retrospective study of South Carolina residents >/=13 years old who were diagnosed with HIV infection in 2004-2007 and initially entered in care. CD4 count/percent and viral load (VL) tests that must be reported to the South Carolina HIV surveillance database were used as a proxy for a clinical visit. Retention was defined as at least one visit in each of four 6-month periods over 2 years postlinkage. Retention rates were categorized as optimal sporadic (visits in two or one intervals), and "dropout" (no visits). Logistic regression and Cox proportional analyses were used to examine retention. Of the 2197 persons, about 50% failed to maintain optimal retention in care postlinkage. Male gender, nonwhite race/ethnicity, younger age, delayed linkage, and HIV-only status were significant predictors of lower rate of retention. Mean decrease in baseline log(10) VL was greater among those with optimal compared to suboptimal (-1.81 vs. -1.42; p < 0.001) and sporadic retention (-1.81 vs. -0.70; p < 0.001). Mean increase in baseline CD4 count was greater in optimal retention compared to suboptimal (169.70 vs. 107.5; p < 0.001) and sporadic retention (169.70 vs. 2.43; p < 0.001). Increased risk of mortality was associated with sporadic retention (aHR 2.91; 95% CI 1.54-5.50) and "dropout" (aHR 4.00; 95% CI 1.50-10.65). Rate of poor retention in early HIV medical care was relatively higher than reported in clinic-based data. Increasing the rate of retention in early HIV care could substantially improve viro-immunological parameters and survival outcomes.
机译：当前有关保留在HIV护理中的文献未能说明持续/同时访问不同提供者的患者。这项全州研究调查了早期HIV医疗保健中的保留率及其对病毒免疫学改善和生存结果的影响。这是一项对2004年至2007年被诊断出患有HIV感染并最初接受护理的南卡罗来纳州13岁以上居民的回顾性研究。必须向南卡罗来纳州HIV监测数据库报告的CD4计数/百分比和病毒载量（VL）测试被用作临床就诊的代理。保留定义为链接后2年内在四个6个月期间的至少每个访问中一次。保留率分为最佳散发性（两次或一次访问）和“辍学”（无访问）。 Logistic回归和Cox比例分析用于检查保留率。在2197人中，约50％未能在护理后链接中保持最佳的保留。男性，非白人种族/种族，年龄较小，联系延迟和仅接受HIV感染是降低保留率的重要指标。与最佳患者相比，基线对数loglog（10）VL的平均降低幅度更大（-1.81 vs. -1.42; p <0.001）和零星保留（-1.81 vs.0.70; p <0.001）。与最佳患者（169.70比107.5; p <0.001）和零星患者保留（169.70比2.43; p <0.001）相比，最佳保留率中基线CD4计数的平均增加更大。死亡风险增加与散发性retention留（aHR 2.91; 95％CI 1.54-5.50）和“辍学”（aHR 4.00; 95％CI 1.50-10.65）相关。早期艾滋病毒医疗中的retention留率较基于临床数据的报道要高。提高早期艾滋病毒治疗的保留率可以大大改善病毒免疫学参数和生存结果。

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