Factors associated with the frequency of monitoring of liver enzymes, renal function and lipid laboratory markers among individuals initiating combination antiretroviral therapy: a cohort study

BMC Infectious Diseases

Research Article

Julio SG Montaner¹  Robert S Hogg²  Nima Machouf³  Marina B Klein⁴  Chris Tsoukas⁴  Janet Raboud⁵  Jennifer Gillis⁵  Curtis Cooper⁶  Ahmed M Bayoumi⁷  Ann N Burchell⁸  Mona Loutfy⁹ 

[1] British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada;British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada;Simon Fraser University, Burnaby, Canada;Clinique Médicale l’Actuel, Montreal, Canada;McGill University Health Centre, McGill University, Montreal, Canada;Toronto General Research Institute, University Health Network, Toronto, Canada;University of Toronto, Toronto, Canada;University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Canada;University of Toronto, Toronto, Canada;Centre for Research on Inner City Health, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada;University of Toronto, Toronto, Canada;Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada;Department of Family and Community Medicine, St. Michael’s Hospital, Toronto, Ontario, Canada;University of Toronto, Toronto, Canada;Women’s College Research Institute, Toronto, Canada;Maple Leaf Medical Clinic, Toronto, Canada;

关键词: HIV;    Antiretroviral therapy;    Laboratory markers;    Liver enzymes;    Renal function;    Lipids;    Clinical monitoring;   

DOI  :  10.1186/s12879-015-1206-3

 received in 2015-05-19, accepted in 2015-10-12,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundAs the average age of the HIV-positive population increases, there is increasing need to monitor patients for the development of comorbidities as well as for drug toxicities.MethodsWe examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels among participants of the Canadian Observational Cohort (CANOC) collaboration which follows people who initiated HIV antiretroviral therapy in 2000 or later. We used zero-inflated negative binomial regression models to examine the associations of demographic and clinical characteristics with the rates of measurement during follow-up. Generalized estimating equations with a logit link were used to examine factors associated with gaps of 12 months or more between measurements.ResultsElectronic laboratory data were available for 3940 of 7718 CANOC participants. The median duration of electronic follow-up was 3.5 years. The median (interquartile) rates of tests per year were 2.76 (1.60, 3.73), 2.55 (1.44, 3.38) and 1.42 (0.50, 2.52) for liver, renal and lipid parameters, respectively. In multivariable zero-inflated negative binomial regression models, individuals infected through injection drug use (IDU) were significantly less likely to have any measurements. Among participants with at least one measurement, rates of measurement of liver, renal and lipid tests were significantly lower for younger individuals and Aboriginal Peoples. Hepatitis C co-infected individuals with a history of IDU had lower rates of measurement and were at greater risk of having 12 month gaps between measurements.ConclusionsHepatitis C co-infected participants infected through IDU were at increased risk of gaps in testing, despite publicly funded health care and increased risk of comorbid conditions. This should be taken into consideration in analyses examining factors associated with outcomes based on laboratory parameters.

【 授权许可】

CC BY   
© Gillis et al. 2015