| Summary: | 碩士 === 國立成功大學 === 護理學系 === 102 === Background: In Taiwan, free access to highly active antiretroviral therapy (HAART) has been provided to people living with HIV since 1997. At the end of 2012, 12,602 (61.7%) of 20,438 people living with HIV were treated with HAART in Taiwan. Optimal virological suppression is the indicator for treatment outcome. The study purpose is to determine the duration and the associated factors of virological suppression among people treated by HAART.
Methods: Eligible participants were initiating HAART for at least 6 months during 2008 to 2012 whom were followed up at a HIV-designated hospital in southern Taiwan. Kaplan-Meier survival analysis and Cox proportional hazard model were used to estimate time and factors associated with virological suppression by HAART.
Results: A total of 250 patients were included in the study cohort with mean age of 33±10 (range 16-76) years, 95% were male, and 70% reported men having sex with men as a primary behaviors for HIV transmission. Most of patients (90.8%) have enrolled in the hospital-based case management program. The mean duration of HAART is 28±14 months (range 7-58 months). After 3 months of treatment initiation, 56% had reached at least one event of undetectable viral load, and 98% achieved virological suppression after 36 months. Overall, 81% (n=203) had successfully maintained a consistent viral suppression (median=102 weeks) after the first undetectable viral load. In the Cox proportional hazard model, an adherence of 95% (adj.HR 2.1, 95% CI 1.359-3.247) and regular retention in care (adj.HR 2.9, 95% CI 1.24-7.13) were two facilitators to viral suppression. But, unemployment (adj. HR 0.43, 95% CI 0.21-0.85) and initial viral load level greater than 10,000 unit (adj. HR 0.309 ＆ 0.173) were barriers to viral suppression.
Conclusion: About 88% of patients had reached first viral suppression within 6 months of HAART. Adherence to HAART represents the strongest factor associated with virological suppression. Identification of patients with unemployment or have barriers to adhere medical regimen may ensure the delivery of the optimal benefit of HAART.
|
|---|
