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An antiretroviral regimen containing 6 months of stavudine followed by long-term zidovudine for first-fine HIV therapy is optimal in resource-limited settings: a prospective, multicenter study in China 被引量:7
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作者 Li Taisheng Guo Fuping +19 位作者 Li Yijia Zhang Chengda Han Yang Lye Wei He Yun Lu Hongzhou Xie Jing Huang Aiqiong Li Yanling Tang Xiaoping Wang Hui Zhang Tong Gao Guiju Lei Junkang Zhang Xiaoying Wu Xinhua Sun Yongtao Bai Jinsong Luo Ling Wang Huanlmg 《Chinese Medical Journal》 SCIE CAS CSCD 2014年第1期59-65,共7页
Background An zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associat... Background An zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resourcelimited settings.However,evidence is scarce.This study aims to assess the efficacy and safety of AZT-substitution regimen,aiming to find a regimen with better efficacy,less adverse events,and more affordability in resource-limited settings.Methods This prospective,multicenter study enrolled 499 (190 on d4T regimen,172 on AZT regimen,and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011.Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens.Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4,12,24,36,48,60,72,84,and 96.Results In terms of hematological adverse effects,AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group.In comparison with AZT-substitution group,AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR)for anemia ≥ grade Ⅱ,8.44,95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade Ⅱ,1.86,95% CI 1.19-2.93).The prevalence of lipodystrophy in d4T group was 19.5%,while that in AZT-substitution group was zero.As to antiretroviral efficacy,these three groups showed no differences.Conclusion AZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings. 展开更多
关键词 human immunodeficiency virus acquired immunodeficiency syndrome antiretroviral therapy ZIDOVUDINE STAVUDINE anemia LIPODYSTROPHY
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Engaging HIV-infected patients in antiretroviral therapy services: CD4 cell count testing after HIV diagnosis from 2005 to 2009 in Yunnan and Guangxi, China 被引量:5
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作者 ZHANG Yao LU Lin +8 位作者 LI Hui-qin LIU Wei TANG Zhi-rong FANG Hua Jennifer Y. Chen MA Ye ZHAO Yan Ray Y. Chen ZHANG Fu-jie 《Chinese Medical Journal》 SCIE CAS CSCD 2011年第10期1488-1492,共5页
Background The initiation and expansion of China's national free antiretroviral therapy program has led to significant improvement of survival among its participants. Success of further scaling up treatment coverage ... Background The initiation and expansion of China's national free antiretroviral therapy program has led to significant improvement of survival among its participants. Success of further scaling up treatment coverage rests upon intensifying HIV screening and efficient linkage of care. Timely CD4 cell count testing after HIV diagnosis is necessary to determine whether a patient meets criteria for antiretroviral treatment, and represents a crucial link to engage HIV-infected patients in appropriate care, which has not been evaluated in China.Methods We evaluated all patients ≥16 years who tested HIV positive from 2005 to 2009 in Yunnan and Guangxi.Multivariate Logistic regression models were applied to identify factors associated with lack of CD4 cell count testing within 6 months after HIV diagnosis.Results A total of 83 556 patients were included. Over the study period, 30 635 (37%) of subjects received a CD4 cell count within 6 months of receiving the HIV diagnosis. The rate of CD4 cell count testing within 6 months of HIV diagnosis increased significantly from 7% in 2005 to 62% in 2009. Besides the earlier years of HIV diagnosis, negative predictors for CD4 cell count testing in multivariate analyses included older age, not married or unclear marriage status,incarceration, diagnosis at sexual transmitted disease clinics, mode of HIV transmission classified as men who have sex with men, intravenous drug users or transmission route unclear, while minority ethnicity, receipt of high school or higher education, diagnosis at voluntary counseling and testing clinics, and having HIV positive parents were protective.Conclusions Significant progress has been made in increasing CD4 testing among newly diagnosed HIV positive patients in Yunnan and Guangxi from 2005-2009. However, a sizable proportion of HIV positive patients still lack CD4testing within 6 months of diagnosis. Improving CD4 testing, particularly among patients with identified risk factors, is essential to link patients with ART services and optimize treatment coverage 展开更多
关键词 human immunodeficiency virus CD4 cell count testing care linkage risk factors
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