Interdisciplinary in managing hiv/aids infected patients-the importance of teamwork

MEDICAL-SURGICAL JOURNAL-REVISTA MEDICO-CHIRURGICALA(2022)

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摘要
The role of an interdisciplinary approach is use-ful in maintaining a good quality of life and low mortality rates among HIV-infected people. A better understanding of the evolution of comorbidities may help to improve the clinical management of HIV/AIDS patients. Material and methods: We performed a retrospective study between 1st of January and the 1st of December 2022 including 1157 patients who have been admitted to Iasi HIV/AIDS Regional Center, from "Sf. Parascheva" Clinical Hospital of Infectious Diseases, in order to identify the main factors that lead to major imbalances in the status of patients with HIV/AIDS infection, highlighting the most common comorbidi-ties. Results: In the study period, 1,157 (70.46%) patients were admitted, and 89 cases (5.48%) were newly diagnosed. The study patients were virologically and immunologically evaluated. It was observed that 12.62% of cases had a CD4 level between 1-200 cells/mm3, in 58.95% of cases the CD4 value was between 201-500 cells/mm3, and 28.44% of patients had CD4 over 501 cells/mm3, with an average CD4 level of 375.28 cells/mm3. The average of HIV viral load was 107.46 copies/mL. Out of the total of 1157 cases, 146 (12.62%) pa-tients had a CD4 level under 200 cells/mm3, considered to have a viro-immunological fail-ure, and they were recommended other antiretroviral regimens, most of them being pre-scribed a single tablet regimen. Depending on the related comorbidities, 62.32% of the 1157 cases admitted in our clinic required interdisciplinary examinations. In descending order, the following conditions were the most common comorbidities that the patients presented: meta-bolic (45.20%), dermatological (31.20%), ENT (12.79%), gastrointestinal (10.29%), infec-tious diseases (9.16%), cardiovascular issues (5.10%), psychiatric disorders (4.06%), pulm o -nary (3.54%), neurological (2.68%), ophthalmic (1.21%), and hematological conditions (0.78%). Out of the newly diagnosed cases, 85.39% were recommended single tablet regi-men and in 14,61% cases were given a regimen that took into account their comorbidities. A large percentage of patients (82.20%) were evaluated through psychological consultation to ensure compliance and adherence to antiretroviral treatment, thus helping a better under-standing of their disease for effective management. Conclusions: Multidisciplinary strate-gies for HIV have become more prevalent as various scientific environments have evolved. Assessing risk behaviors, clinical manifestations, health status, psycho-behavioral and cul-tural factors, as well as HIV assistance have emerged
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关键词
HIV,AIDS,COMORBID-ITIES,ANTIRETROVIRAL THERAPY,INTERDISCIPLINARY
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