背景：台灣於1997年引進高效能抗愛滋病毒療法並利用全民健康保險給付免費提供給愛滋病毒感染者 (CD4細胞數<350 cells/mm3) 使用。截至西元2012年底，台灣20,438名感染者中共有約12,602 (61.7%) 接受過治療。
重要性：血中病毒量抑制是評估療效的重要指標且對病人的病程進展及預後都扮演著重要的角色。
目的：確認感染者在服藥期間逹到病毒抑制的變化及其相關因素。
方法：本研究為次級資料分析，併用病歷瀏覽方式收集分析2008年1月到2012年12月於台南某醫學中心服用抗病毒藥滿六個月之HIV感染者資料。以Kaplan-Meier存活曲線計算從服藥至達到病毒抑制的時間，並使用Cox Proportional-Hazards model進行相關因子分析。
結果：共有250位個案符合資格並納入分析。個案平均年齡為33±10 (範圍 : 16-76)歲，男性佔了95%且70% 是經由男男性交感染到愛滋病毒。有90.8% 的個案都曾經加入過愛滋病個案管理計劃。平均的服藥時間為28±14月(範圍：7-58個月)。在接受治療3個月內,有56% 的人達成第一次的病毒抑制 (小於400 copies/ml)。而治療六個月內的達成率為87.6%。總共有81.2% (n=203)的患者達成持續性的病毒抑制(中位數：102周)。理想的服藥遵從度( 95%, adj.HR 2.1, 95% CI 1.359-3.247)、規律返診(adj.HR 2.9, 95% CI 1.24-7.13)有助達到病毒抑制；反之,無職業者(adj.HR 0.43, 95% CI 0.21-0.85)及初始血清病毒量大於一萬單位(adj. HR 0.309 & 0.173)不利於達到病毒抑制。
結論：研究結果顯示服藥六個月內病毒抑制達成率將近88%；再者,共有81% (203人) 在第一次病毒抑制後就一直維持理想血中病毒量直到研究終期。服藥遵從度，未規則返診及無固定職業為可能影響患者達到血中病毒抑制的因子。及時的發現及協助具有相關因子的高危險群將有助提升病人的治療效果。

Background: In Taiwan, free access to highly active antiretroviral therapy (HAART) has been provided to people living with HIV since 1997. At the end of 2012, 12,602 (61.7%) of 20,438 people living with HIV were treated with HAART in Taiwan. Optimal virological suppression is the indicator for treatment outcome. The study purpose is to determine the duration and the associated factors of virological suppression among people treated by HAART.
Methods: Eligible participants were initiating HAART for at least 6 months during 2008 to 2012 whom were followed up at a HIV-designated hospital in southern Taiwan. Kaplan-Meier survival analysis and Cox proportional hazard model were used to estimate time and factors associated with virological suppression by HAART.
Results: A total of 250 patients were included in the study cohort with mean age of 33±10 (range 16-76) years, 95% were male, and 70% reported men having sex with men as a primary behaviors for HIV transmission. Most of patients (90.8%) have enrolled in the hospital-based case management program. The mean duration of HAART is 28±14 months (range 7-58 months). After 3 months of treatment initiation, 56% had reached at least one event of undetectable viral load, and 98% achieved virological suppression after 36 months. Overall, 81% (n=203) had successfully maintained a consistent viral suppression (median=102 weeks) after the first undetectable viral load. In the Cox proportional hazard model, an adherence of 95% (adj.HR 2.1, 95% CI 1.359-3.247) and regular retention in care (adj.HR 2.9, 95% CI 1.24-7.13) were two facilitators to viral suppression. But, unemployment (adj. HR 0.43, 95% CI 0.21-0.85) and initial viral load level greater than 10,000 unit (adj. HR 0.309 & 0.173) were barriers to viral suppression.
Conclusion: About 88% of patients had reached first viral suppression within 6 months of HAART. Adherence to HAART represents the strongest factor associated with virological suppression. Identification of patients with unemployment or have barriers to adhere medical regimen may ensure the delivery of the optimal benefit of HAART.

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