南部某醫學中心接受個案管理之HIV感染者之相關症狀

HIV-Related Symptoms in Patients with HIV Infection Enrolled in an HIV Case Management Program in Taiwan

隨著人類免疫缺乏病毒(human immunodeficiency virus, HIV)病程變化，感染者經歷多種HIV相關症狀，症狀亦與抗愛滋病毒藥物治療之副作用與合併症有關。本研究目的為描述定期於門診追蹤之HIV感染者其相關症狀、頻率、強度及症狀與病程進展、抗愛滋病毒藥物治療用藥類型的關係。採現存資料分析，分析南部某醫學中心172位參與HIV個案管理感染者之基礎資料。結果顯示，每人平均約9.73±7.27種症狀，頻率最高之症狀為疲憊、口乾、虛弱；強度平均約13.24±11.48分，強度最高之症狀為失眠、憂鬱、失去定向感。HIV症狀數目、強度與病程進展、診斷年數無顯著關係。核苷酸反轉錄酶抑制劑和非核苷酸反轉錄酶抑制劑類與核苷酸反轉錄酶抑制劑和蛋白酶抑制劑類藥物組合，二者在疲憊症狀之平均強度，有顯著差異(p=.03)。將症狀種類叢聚後，未服用抗愛滋病藥物者在困惑／苦惱構面部份其症狀強度顯著高於已服藥者(t=2.0, df=1, p=.04)。未來應發展有效改善疲憊的措施，加強精神症狀之評估與診斷，並及早給予處理避免症狀惡化影響其生活品質。

Patients with HIV (human immunodeficiency virus) experience multiple signs and symptoms that accompany the progress of HIV-related diseases. HIV-related symptoms are associated with side effects and HAART (highly active antiretroviral therapy) complications. The purposes of this study were to estimate the frequency and intensity of HIV-related signs and symptoms in patients with HIV infection and to explore relationships between HIV-related symptoms and the HAART regimen. Data on a total of 172 HIV-positive patients enrolled in an HIV case management program were analyzed for this study. Participants experienced an average of 9.73±7.27 symptoms, with fatigue, dry mouth and weakness the most frequently reported. Average mean symptom intensity among participants was 13.24±11.48. Insomnia, depression and disorientation were the most severe symptoms. No differences were recorded between HIV-related symptoms and disease progression. Fatigue intensity showed significant differences between NRTI (nucleoside reverse transcriptase inhibitors), +NNRTI (non-nucleoside reverse transcriptase inhibitors) and NRTI+PI (protease inhibitors) based regimens (p=.03). In addition, cluster symptoms of confusion/distress among participants without HAART had a significantly higher mean intensity than those with HAART (t=2.0, df=1, p=.04). Our study indicated that symptom management for fatigue and early detection of psychological distress is needed to improve quality of life for people living with HIV/AIDS.