台灣愛滋感染者使用抗反轉錄病毒藥物的情況及發生高血脂的風險
| Autor: | Chun-Yi Lin, 林峻毅 |
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| Rok vydání: | 2016 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 104 Background: Antiretroviral Therapy (ART) plays an important role in controlling the progression of HIV/AIDS. However, the side effects from the ART often make patients have low medication adherence. This study aimed to explore the use of ART and medication adherence on HIV-infected patients from National Health Insurance Research Database (NHIRD) in Taiwan, and investigated whether the use of ART may increase hyperlipidemia risk. Materials and Methods: The data used in this study came from the Taiwan Longitudinal Health Insurance Database (NHID 2000 and NHID 2005). Each database consists of 1,000,000 beneficiaries randomly selected from all National Health Insurance enrollees in 2000 or 2005. The HIV-infected patients were defined by ICD-9-CM code (042, 043, 044, V08) from 2000 to 2012. The ART information used in this study came from Ministry of Health and Welfare. The Kaplan-Meier method was used to assess the cumulative probability for the time to start ART. The logistic regression was used for assessing the influential factors of the ART adherence. In addition, we applied a matched nested case-control design to investigate the effects of ART on the incidence of hyperlipidemia. We selected 4 matched-controls for each case using incidence density sampling. We then applied the conditional logistic regression model to assess the risk factor for occurrence of hyperlipidemia in HIV-infected patients. Moreover, we assessed the risk of ART use on the occurrence of hyperlipidemia stratifying by risk factor. Result: Male, higher age of HIV infection, income more than Twenty thousand NT dollars, later time to start using the ART were more likely to have higher adherence. Compared with no-ART users, higher cumulative ART users had higher risk to occurrence the hyperlipidemia. Conclusion: The use of ART may increase hyperlipidemia risk in HIV-infected patients. Further studies may investigate the effects of types of ART, dosage of ART and related comorbidities and their medications on the occurrence of hyperlipidemia. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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