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Análise da relação de supressão viral com medidas clínicas de atendimento aos pacientes adultos vivendo com o HIV/SIDA
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Abstract(s)
A prevalência do Vírus da Imunodeficiência Humana (HIV) em todo o mundo, destaca a importância de adoção de estratégias eficazes para a supressão viral, com foco nos pacientes com comorbidades para países em vias de desenvolvimento. Nessa perspetiva, o objetivo deste estudo, foi de analisar a relação entre a supressão viral com as medidas clínicas de atendimento aos pacientes adultos vivendo com o HIV no Centro de Saúde da Cidade de Lichinga, entre os anos 2020 e 2021. Foram analisadas as seguintes variáveis independentes: Tuberculose (TB), o Peso corporal, Sexo, a Idade, Tempo de tratamento e Apoio Psicossocial. Utilizando o teste de qui-quadrado e a regressão logística múltipla, foram analisados dados de 342 pacientes adultos. Os principais resultados encontrados são os seguintes: a presença da TB nos pacientes com HIV reduz em 97% a probabilidade de alcançar a supressão viral, dada a Odds Ratio (OR=0.03); Um quilograma de aumento do Peso Corporal, a chance de supressão viral é de 83% (OR=1.83); A cada mês de Tratamento Antirretroviral (TARV) ininterrupto, a probabilidade é muito acima de 100% (OR=5.11); Outra descoberta é o impacto da interação entre a presença da TB e alto Apoio Psicossocial, sugerindo que a prestação de cuidados e Apoio Psicossocial aos pacientes com coinfecção de TB e HIV, aumenta mais rapidamente a chance de alcançar a supressão viral nesses pacientes do que aqueles que não tiveram Apoio Psicossocial dada a OR=48.50 e por fim, houve a descoberta da interação dos fatores Tempo de Tratamento e Peso Corporal. Com estes resultados, pode se concluir que: aos pacientes em TARV, há necessidade de diagnóstico precoce de outras doenças, como é o caso da TB; por outro lado, o reforço do Apoio Psicossocial e o controlo do Peso é fundamental. Estas conclusões são validadas pelos resultados do Pseudo R² (Cox e Snell= 68.2% e Nagelkerke = 92.6%). O teste de Hosmer-Lemeshow confirma a validade desta teoria (p-valor de 99.56%) e por fim, a curva Receiver Operating Characteristic (ROC= 99.4%).
The Prevalence of Human Immunodeficiency Virus (HIV) worldwide highlights the importance of adopting effective strategies for viral suppression, focusing on patients with comorbidities in developing countries. In this context, the objective of this study was to analyze the relationship between viral suppression and clinical measures for the care of adult patients living with HIV at the Health facility at the Lichinga City, between years 2020 and 2021. The following independent variables were analyzed: Tuberculosis (TB), Body Weight, Gender, Age, Treatment Duration and Psychosocial Support. Using the chi-square test and multiple logistic regression, data from 342 adult patients were analyzed. The main findings are as follows: the presence of TB in an HIV patients reduces the probability of achieving viral suppression by 97%, given the Odds Ratio (OR=0.03); One kilogram of Body Weight increase, the chance of viral suppression is 83% (OR=1.83); For each month of uninterrupted Antiretroviral Treatment (ART), the probability is over than 100% (OR=5.11); Another finding is the impact of the interaction between TB presence and high Psychosocial Support, suggesting that the provision of care and Psychosocial Support to patients with TB and HIV coinfection, increases the chance of achieving viral suppression more quickly than those who did not receive Psychosocial Support, given an OR=48.50. Finally, the interaction between Treatment Duration and body weight was discovered. Based on these results, it can be concluded that: for patients on ART, there is a need for early diagnosis of other diseases, such as TB as well as a strengthening Psychosocial Support and monitoring the body weight, is essential. These conclusions are validated by the Pseudo R² results (Cox and Snell= 68.2% and Nagelkerke = 92.6%). The Hosmer-Lemeshow test confirms the validity of this theory (p-value of 99.56%), and finally, the Receiver Operating Characteristic curve (ROC=99.4%).
The Prevalence of Human Immunodeficiency Virus (HIV) worldwide highlights the importance of adopting effective strategies for viral suppression, focusing on patients with comorbidities in developing countries. In this context, the objective of this study was to analyze the relationship between viral suppression and clinical measures for the care of adult patients living with HIV at the Health facility at the Lichinga City, between years 2020 and 2021. The following independent variables were analyzed: Tuberculosis (TB), Body Weight, Gender, Age, Treatment Duration and Psychosocial Support. Using the chi-square test and multiple logistic regression, data from 342 adult patients were analyzed. The main findings are as follows: the presence of TB in an HIV patients reduces the probability of achieving viral suppression by 97%, given the Odds Ratio (OR=0.03); One kilogram of Body Weight increase, the chance of viral suppression is 83% (OR=1.83); For each month of uninterrupted Antiretroviral Treatment (ART), the probability is over than 100% (OR=5.11); Another finding is the impact of the interaction between TB presence and high Psychosocial Support, suggesting that the provision of care and Psychosocial Support to patients with TB and HIV coinfection, increases the chance of achieving viral suppression more quickly than those who did not receive Psychosocial Support, given an OR=48.50. Finally, the interaction between Treatment Duration and body weight was discovered. Based on these results, it can be concluded that: for patients on ART, there is a need for early diagnosis of other diseases, such as TB as well as a strengthening Psychosocial Support and monitoring the body weight, is essential. These conclusions are validated by the Pseudo R² results (Cox and Snell= 68.2% and Nagelkerke = 92.6%). The Hosmer-Lemeshow test confirms the validity of this theory (p-value of 99.56%), and finally, the Receiver Operating Characteristic curve (ROC=99.4%).
Description
Dissertação de Mestrado em Bioestatística e Biometria, apresentada à Universidade Aberta
Keywords
Supressão viral SIDA Regressão logística Terapia antirretroviral Viral load suppression HIV/AIDS Logistic regression Antiretroviral therapy
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