2026-05-20T01:01:48Z https://meral.edu.mm/oai

oai:meral.edu.mm:recid/00007860 2021-12-13T00:26:22Z 1607984359018:1608053322572 user-um2

HIV care in Yangon, Myanmar; successes, challengesand implications for policy Ne Myo Aung Hanson, Josh Tint Tint Kyi Zaw Win Htet Cooper, David A. Boyd, Mark A. Mar Mar Kyi Htin Aung Saw Background: Approximately 0.8% of adults aged 18–49 in Myanmar are seropositive for Human Immunodeficiency Virus (HIV ). Identifying the demographic, epidemiological and clinical characteristics of people living with HIV (PLHIV ) is essential to inform optimal management strategies in this resource-limited country.Methods: To create a “snapshot” of the PLHIV seeking anti-retroviral therapy (ART ) in Myanmar, data were collected from the registration cards of all patients who had been prescribed ART at two large referral hospitals in Yangon, prior to March 18, 2016.Results and discussion: Anti-retroviral therapy had been prescribed to 2643 patients at the two hospitals. The patients’ median [interquartile range (IQR)] age was 37 (31–44) years; 1494 (57%) were male. At registration, inject-ing drug use was reported in 22 (0.8%), male-to-male sexual contact in eleven (0.4%) and female sex work in eleven (0.4%), suggesting that patients under-report these risk behaviours, that health care workers are uncomfortable enquiring about them or that the two hospitals are under-servicing these populations. All three explanations appear likely. Most patients were symptomatic at registration with 2027 (77%) presenting with WHO stage 3 or 4 disease. In the 2442 patients with a CD4+ T cell count recorded at registration, the median (IQR) count was 169 (59–328) cells/mm3. After a median (IQR) duration of 359 (185–540) days of ART, 151 (5.7%) patients had died, 111 (4.2%) patients had been lost to follow-up, while 2381 were alive on ART. Tuberculosis (TB) co-infection was common: 1083 (41%) were already on anti-TB treatment at registration, while a further 41 (1.7%) required anti-TB treatment during follow-up. Only 21 (0.8%) patients were prescribed isoniazid prophylaxis therapy (IPT ); one of these was lost to follow-up, but none of the remaining 20 patients died or required anti-TB treatment during a median (IQR) follow-up of 275 (235–293) days.Conclusions: People living with HIV in Yangon, Myanmar are generally presenting late in their disease course, increasing their risk of death, disease and transmitting the virus. A centralised model of ART prescription struggles to deliver care to the key affected populations. TB co-infection is very common in Myanmar, but despite the proven efficacy of IPT, it is frequently not prescribed. 2021-01-28 http://hdl.handle.net/20.500.12678/0000007860 https://meral.edu.mm/records/7860