Health conditions influence in virologic outcomes in a population living with HIV: a retrospective observational study

Abstract

Objective: To correlate health conditions, linking the primary health care and municipal Human Development Index with the virological outcomes of HIV treatment, in a population over 13 years old, in the region of Vale do Jequitinhonha, north of Minas Gerais. Methods: A retrospective review of 239 medical records, from 1995 to 2020 was performed in a regional reference service. The risk for an unfavorable HIV PCR blood test result was initially estimated by a chi square test, simple logistic regression, Pearson’s and Spearman’s correlations, considering a 95% significance level. Subsequently, multivariate analysis was performed to build a decision tree for a risk profile of treatment failure. Results: 92 users had a weak link with primary health care and 12 presented treatment failure. Conditions that reduced the risk of a favorable treatment response were systemic arterial hypertension (OR=0.13; 95%CI=0.13-0.47), psychosocial conditions (OR=0.06; 95%CI=0.00-0.32), visceral leishmaniasis (OR=0.07; 95%CI=0.01-0.58), and CD4 T lymphocytes level under 350 cells/mm3 (OR=0.10; 95%CI=0.02-0.39). Positive correlation (p<0.05) was observed between the Human Development Index and treatment failures (COR=0.5; 95%CI=0.1-0.7). Conclusion: Systemic arterial hypertension and CD4 T lymphocyte levels under 350 cells/mm3 were the most relevant conditions in a decision tree model for a profile for treatment failure risk.

Keywords

• hiv
• aids
• chronic disease
• coinfection
• primary health care