• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>AIDS care. >Disparities in achieving and sustaining viral suppression among a large cohort of HIV-infected persons in care - Washington, DC
【24h】

Disparities in achieving and sustaining viral suppression among a large cohort of HIV-infected persons in care - Washington, DC

机译：一大批艾滋病毒感染者在护理中实现和维持病毒抑制的差异-华盛顿特区

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

One goal of the HIV care continuum is achieving viral suppression (VS), yet disparities in suppression exist among subpopulations of HIV-infected persons. We sought to identify disparities in both the ability to achieve and sustain VS among an urban cohort of HIV-infected persons in care. Data from HIV-infected persons enrolled at the 13 DC Cohort study clinical sites between January 2011 and June 2014 were analyzed. Univariate and multivariate logistic regression were conducted to identify factors associated with achieving VS (viral load<200 copies/ml) at least once, and Kaplan-Meier (KM) curves and Cox proportional hazards models were used to identify factors associated with sustaining VS and time to virologic failure (VL200 copies/ml after achievement of VS). Among the 4311 participants, 95.4% were either virally suppressed at study enrollment or able to achieve VS during the follow-up period. In multivariate analyses, achieving VS was significantly associated with age (aOR: 1.04; 95%CI: 1.03-1.06 per five-year increase) and having a higher CD4 (aOR: 1.05, 95% CI 1.04-1.06 per 100 cells/mm(3)). Patients infected through perinatal transmission were less likely to achieve VS compared to MSM patients (aOR: 0.63, 95% CI 0.51-0.79). Once achieved, most participants (74.4%) sustained VS during follow-up. Blacks and perinatally infected persons were less likely to have sustained VS in KM survival analysis (log rank chi-square p.001 for both) compared to other races and risk groups. Earlier time to failure was observed among females, Blacks, publically insured, perinatally infected, those with longer standing HIV infection, and those with diagnoses of mental health issues or depression. Among this HIV-infected cohort, most people achieved and maintained VS; however, disparities exist with regard to patient age, race, HIV transmission risk, and co-morbid conditions. Identifying populations with disparate outcomes allows for appropriate targeting of resources to improve outcomes along the care continuum.
机译：HIV护理连续性的目标之一是实现病毒抑制（VS），但是在HIV感染者的亚人群中，抑制方面存在差异。我们试图找出在城市艾滋病毒感染者队列中实现和维持VS的能力方面的差异。分析了2011年1月至2014年6月在13个DC Cohort研究临床地点招募的HIV感染者的数据。进行单因素和多因素logistic回归以鉴定至少一次达到VS（病毒载量<200拷贝/ ml）的相关因素，并使用Kaplan-Meier（KM）曲线和Cox比例风险模型确定与维持VS和相关的因素。达到病毒学失败的时间（达到VS后达到VL200拷贝/ ml）。在4311名参与者中，有95.4％在研究入组时被病毒抑制或在随访期间能够达到VS。在多变量分析中，达到VS与年龄显着相关（aOR：1.04; 95％CI：每五年增加1.03-1.06），而CD4更高（aOR：1.05，95％CI每100个细胞/ mm 1.04-1.06） （3））。与MSM患者相比，通过围产期传播感染的患者获得VS的可能性较小（aOR：0.63，95％CI 0.51-0.79）。一旦达到目标，大多数参与者（74.4％）会在随访过程中保持VS。与其他种族和高危人群相比，黑人和围生期感染者在KM生存分析中持续VS的可能性较小（两者的对数均秩均为p.001）。在女性，黑人，公共保险，围产期感染，长期感染艾滋病毒的女性以及诊断为精神健康问题或抑郁症的女性中，观察到较早出现衰竭。在这个被艾滋病毒感染的人群中，大多数人达到并维持了VS。但是，在患者年龄，种族，HIV传播风险和合并症方面存在差异。确定具有不同结果的人群可适当确定资源目标，以改善整个护理过程的结果。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号