heart failure , diabetes , chronic obstructive pulmonary disease ( COPD ), asthma , and mood disorders . Lastly , the patient ’ s viral load ( VL ) and CD4 count at the time of establishment with the RW clinic was recorded . CD4 count and VL at the time of establishment were recorded , and their means analyzed using a t-test . A binary logistic regression model was applied to determine any difference in risk factors and comorbids between patients infected within WV and those infected outside of the state .
Using the CAREWare software , an electronic health information system developed for RW services , patient data on retention of care , and engagement was also determined . Retention of care was defined as the ratio of established patients at the beginning of a calendar year plus the new patients seen that year compared to the number of total patients seen by the end of that calendar year . Viral suppression was defined as aVL of less than 200 copies at the last sampling . The latest data reported was available from February 2019 at the time of data collection .
Approval was obtained from the Institutional Review Board at the WVU School of Medicine prior to the start of data collection . Statistical analysis was conducted using the statistical software IBM SPSS Statistics for Windows , Version 23.0 . Armonk , NY : IBM Corp .
RESULTS
A total of 372 patients established at the RW clinic during the study time frame . Of these patients , 305 ( 81.7 %) patients were male , with mean age at establishment with the RW clinic of 40 years , and mean age at diagnosis of 33 years . Patients with newly diagnosed HIV comprised 38 % of the cohort entering care , while 62 % had previously received HIV care at other facilities . Thirty-eight patients ( 10.2 %) had a diagnosis of Hepatitis C infection in addition to HIV , with 22 ( 5.9 %) patients reporting Hepatitis B infection . Among non-infectious comorbid factors , a diagnosis of mood disorder was reported in 71 ( 19.0 %). Hypertension was the next most common comorbid factor ( 18.0 %), followed by both diabetes mellitus and asthma , recorded in 4.8 % of patients .
TABLE 1 : Characteristics of the Study Population Gender Number Percentage Male 305 81.7 Female 67 18.3 HIV Status at Establishment Number Percentage Newly diagnosed , entering care 141 37.9 Previously received care 229 61.6 Incomplete documentation 2 0.5 Age Range at Establishment Number Percentage 18-25 50 13.4 26-35 92 24.7 36-45 106 28.5 46-55 86 23.1 6-65 29 7.8 66 + 9 2.4 HIV Infection First Detected Number Percentage WV 170 45.7 Outside WV 202 54.3 State Where Patient Likely Infected Number Percentage WV 122 32.8 Outside WV 233 62.8 Unable to determine 17 4.6 Risk Factors Number Percentage Sexual Transmission 318 85.5 IDU 40 10.8 Blood-borne 3 0.8 Unknown 12 3.2 Comorbid Conditions Number Percentage Hypertension 67 18.0
Diabetes Mellitus 18 4.8 COPD 12 3.2 Asthma 18 4.8 Depression / Anxiety 71 19.0 CHF 2 0.5 Hepatitis B 22 5.9 Hepatitis C 38 10.2
HIV = Human immunodeficiency virus ; IDU = Injection drug use ; WV = West Virginia ; COPD = Chronic obstructive pulmonary disease ; CHF = Congestive heart failure
CAREware data revealed a 93 % retention in care , with a 91 % viral suppression rate ( Table 4 ). More than two-thirds ( 69 %) of all patients in the catchment area for our
RW services were estimated to be virologically suppressed , compared to 30 % reported nationally . 8
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