Predicting of the development of aids-indicating opportunistic infections in HIV-infected patients on antiretroviral therapy (retrospective cohort study)

Authors

DOI:

https://doi.org/10.15587/2519-4798.2019.179650

Keywords:

HIV infection, AIDS-indicating opportunistic infections on antiretroviral therapy, prognosis

Abstract

HIV remains one of the actual problems of modern medicine. The search for predictors of the development of AIDS-associated opportunistic infections (OI) in patients on antiretroviral therapy (ART) is an urgent scientific and practical task.

The aim of the study was to investigate the predictors of progression and to create a prognostic model for the development of AIDS-related opportunistic infections in HIV-infected patients receiving ART based on the determination of clinical genetic markers.

Materials and methods. A retrospective cohort study of 181 HIV-infected patients was conducted. Logistic regression and ROC analysis were used for statistical data processing.

Results. As a result of the analysis of 27 potential predictors of the development of AIDS-associated OIs in patients on ART, 10 significant predictors were identified in HIV-infected patients, on which the progression of HIV depends, namely: male sex (OR = 3.30 [95% СΙ 1.21 –9.0], p = 0.020), injecting drugs (OR = 2.49 [95% SO 1.02–6.07], p = 0.044), incarceration experience (OR = 2.29 [95% CI 1.07–4.91], p = 0.033), smoking (OR = 2.46 [95% CI 1.14–5.27], p = 0.021), immunological failure of ART (OR = 4 , 48 [95% CI 1.98–10.13], p = 0.000), low adherence to ART (OR = 3.03 [95% CI 1.13–8.09], p = 0.027), BMI less 18.5 (OR = 6.13 [95% СΙ 2.77–13.56], p = 0.000), haemoglobin level lower than 100 g/L (OR = 2.99 [95% CI 1.41–6.32], p = 0.004), the 299Gly allele of the TLR4 gene carrying (OR = 3.38 [95% CI 1.41–8, 12], p = 0.006) and the normal genotype (Gln11Gln, 11Gln/-) of the TLR7 gene (OR = 2.90 [95% CI 1.06–7.95], p = 0.038).

Conclusions. A prognostic model of 5 predictors (male sex, immunological failure of ART, haemoglobin level lower than 100 g/L, BMI below 18.5 kg/m2 and carrier of the allele 299Gly of the TLR4 gene) was created (statistically significant (χ² = 59.88, g <0.001) with operational characteristics: sensitivity - 73.0%, specificity - 79.0% and had a high predictive efficiency (area under the ROC curve - 0.8580)

Author Biography

Olena Marchenko, Ukrainian Academy of Medical Dental Shevchenko str., 23, Poltava, Ukraine, 36011

Postgraduate Student

Department of Infectious Diseases with Epidemiology

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Published

2019-10-10

How to Cite

Marchenko, O. (2019). Predicting of the development of aids-indicating opportunistic infections in HIV-infected patients on antiretroviral therapy (retrospective cohort study). ScienceRise: Medical Science, (5 (32), 11–17. https://doi.org/10.15587/2519-4798.2019.179650

Issue

No. 5 (32) (2019)

Section

Medical Science

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Copyright (c) 2019 Olena Marchenko

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