The risk of death is high in HIV-infected patients who do not see their doctor regularly

According to a study published in Clinical Infectious Diseases , June 1 - Patients who do not regularly care about their HIV infection have a greater chance of dying compared to those who keep contact. with regular medical visits.

Investigators from the Department of Veterans' Affairs found that, comparing patients who constantly follow treatment after starting HIV infection, missing a quarter without medical examination, the death rate increased by 42%, Compared to those who quit 3 quarters without going to the exam, the probability of dying is 95%.

Effective HIV treatment has improved the diagnosis of HIV-positive patients in industrialized countries. But in order to get the maximum benefit from HIV treatment, it is necessary for HIV-positive people to be diagnosed with any infections before they promote advanced immune suppression. progress, and receive the most special care for HIV disease indefinitely.

Although intuition indicates that HIV-positive patients who are regularly cared for will live longer, but this has not previously been explained for HIV infection or for any other chronic disease. .

The investigators used the nominal name of the Department of Veterans' Affairs, the largest provider of HIV-infected patients in the United States, hypothetical test - poor maintenance and care for HIV-infected people means that Examining and treating patients worse, including death.

(Photo: Faceaids) Census work includes all HIV-positive individuals participating in registrations in 1997 and 1998. Main results - survivors are people after taking care of care. nursing from 1 year. This data was collected at the end of 2004. Information was also collected based on the total count of CD4 cells and viral load after 1 year of starting HIV therapy.

The guidelines for US treatment guidelines suggest that HIV-positive patients should go to the doctor for a quarterly examination, and the investigators have looked at the surviving patient and the treatment results on the number of quarterly visits in throughout the first year of care and maintenance because of HIV disease.

A total of 2,619 people in the study, the HIV disease suddenly increased in most patients in the diagnosis period, the total number of cells counted in the middle of CD4 cells was 228 cells / mm ³ .

In the first year after diagnosis of HIV, 64% of patients had regular attendance in all 4 outpatient care, 18% were present for 3 quarters, 11% for 2 quarters, and 6% only for 1 quarter. never mind.

Significantly combining factors; along with greater participation in treatment visits in the elderly (p <0.01), more than advanced immunosuppression at the time of HIV diagnosis (p <0.01) and receiving therapy by antiretroviral (p = 0.05). Patients with co-infection with hepatitis C (p <0.001), abuse of alcohol (alcohol content) (p <0.0010), or using strong drugs (p <0.001) most of them are less common Through attending care and maintenance sessions for HIV-infected patients.

After 1 year of starting HIV therapy, the total count of CD4 cells was increased between 100 cells / mm ³ in patients who attended full quarterly care sessions in 1 year of follow-up diagnosis, but on average, only 49 cells were found in patients who participated in clinical examination 1 time during the year of follow-up, a significant difference (p <0.001). Likewise, the reduction in viral anxiety is much better than that of patients who regularly follow more care sessions (p ).

A total of 425 patients died after 1 year of care and care for people with HIV. After adjusting for factors such as breeding line, age, total count of CD4 cells, using anti-HIV therapy and co-infection with hepatitis C, investigators believe that maintenance and care HIV patients are getting worse and worse, the risk of death increases very scary. Compared to patients who regularly receive quarterly exams during the year after making a diagnosis for those who miss only once, the risk of death increases by 42% (p <0.001).

The investigators said: 'Patients who are not cared for for only 3 months . are enough to live and struggle.' The findings in this study are particularly interesting when the census facilitates free examination and treatment from VA, which means there is nothing to worry about financial issues at all.

Investigators conclude: 'Strategies for long-term patient care need to be developed, surveyed and supplemented to achieve the highest benefit from current available health care.'

The co-author of this editorial explains: ' Many studies show that patients who have access to care, transportation, mental health promotion, drug treatment and services Other incentives seem to stay to continue taking longer care for patients who do not meet these conditions. 'She added: ' It is also necessary to support patients to expand their positive relationships with health care providers and improve their knowledge of HIV infection and dispel negative thoughts about health.'

Danh Phuong