Taylor Lynn E
Department of Medicine, Division of Infectious Disease, Brown Medical School, Providence, Rhode Island, USA.
Clin Infect Dis. 2005 Apr 15;40 Suppl 5:S355-61. doi: 10.1086/427453.
Injection drug use has fueled the epidemic of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfection in the United States. Nevertheless, drug dependence is among the main reasons that coinfected persons are not being treated for HCV infection. This report describes the development and progress of an HIV clinic program (funded by the Ryan White Comprehensive AIDS Resources Emergency Act) to deliver care for HCV infection to HIV-seropositive injection drug users. To optimize safety and adherence, pegylated interferon is directly administered to patients in the context of integrated addiction, psychiatric, and HIV and HCV therapy. Ribavirin is packed weekly in pill boxes for patients to take at home. Thus far, adherence to weekly visits for treatment with interferon has been 99%. No one has had to stop treatment for HCV infection because of ongoing drug use, addiction relapse or exacerbation, or psychiatric complications. Presented here is a work in progress, rather than a finished research project or definitive model of care.
在美国，注射吸毒助长了人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）合并感染的流行。然而，药物依赖是合并感染患者未接受HCV感染治疗的主要原因之一。本报告描述了一个HIV诊所项目（由瑞安·怀特综合艾滋病资源紧急法案资助）的发展和进展，该项目为HIV血清阳性的注射吸毒者提供HCV感染治疗。为了优化安全性和依从性，聚乙二醇化干扰素在综合成瘾、精神科、HIV和HCV治疗的背景下直接给予患者。利巴韦林每周装在药盒中供患者在家服用。到目前为止，干扰素治疗的每周就诊依从率为99%。没有人因持续吸毒、成瘾复发或病情加重或精神科并发症而不得不停止HCV感染治疗。这里展示的是一项正在进行的工作，而不是一个完成的研究项目或确定的护理模式。
