Guadagnino Vincenzo, Trotta Maria Paola, Montesano Franco, Babudieri Sergio, Caroleo Benedetto, Armignacco Orlando, Carioti Jessica, Maio Giuseppe, Monarca Roberto, Antinori Andrea
Chair of Infectious Diseases, Postgraduate School of Infectious Diseases, University Magna Graecia of Catanzaro, Italy.
Addiction. 2007 Mar;102(3):423-31. doi: 10.1111/j.1360-0443.2006.01698.x.
To evaluate the effect of a multi-disciplinary standardized management model on the efficacy of pegylated (Peg)-interferon alpha-2b plus ribavirin treatment of chronic hepatitis C in drug addicts undergoing substitutive or antagonist therapy.
Observational prospective multi-centre study.
Six clinical infectious disease centres in collaboration with 11 drug dependency units (DDU) in five Italian regions.
Intravenous drug users affected by chronic hepatitis C engaged in detoxification programmes.
Application of a multi-disciplinary standardized management model for HCV treatment involving DDU operators, psychologists or psychiatrists and infectious disease specialists.
Very early, early, end-of-treatment and sustained virological response to Peg-interferon alpha-2b plus ribavirin.
Fifty-three subjects were studied [43.4% with hepatitis C virus (HCV) genotypes 1 or 4]. Intent-to-treat analysis showed an end-of-treatment virological response in 58.5% of patients (39.1% genotypes 1 or 4; 73.4% genotype 3) and a sustained virological response in 54.7% (34.8% genotypes 1 or 4; 70.0% genotype 3). There were 19 (35.8%) dropouts and three (5.7%) non-responders: one genotype 1 and two genotype 4. Two (3.8%) patients relapsed: genotypes 1 and 3. On-treatment analysis showed negative HCV-RNA in 40 (93.1%) of 43 subjects who completed the first 12 treatment weeks and in 35 who completed the first 24 treatment weeks. All subjects with an end-of-treatment response, except one with genotype 3 infection, had a sustained response.
Our data show that antiviral treatment in the context of a multi-disciplinary standardized management model helps many HCV-positive drug addicts achieve a good virological response.
评估多学科标准化管理模式对接受替代或拮抗剂治疗的吸毒成瘾者使用聚乙二醇化（Peg）干扰素α-2b联合利巴韦林治疗慢性丙型肝炎疗效的影响。
观察性前瞻性多中心研究。
意大利五个地区的六个临床传染病中心与11个药物依赖治疗单位（DDU）合作。
接受戒毒计划的慢性丙型肝炎静脉吸毒者。
应用一种涉及DDU工作人员、心理学家或精神科医生以及传染病专家的多学科标准化丙型肝炎治疗管理模式。
对Peg干扰素α-2b联合利巴韦林的极早期、早期、治疗结束时和持续病毒学应答。
研究了53名受试者[43.4%为丙型肝炎病毒（HCV）1型或4型]。意向性分析显示，58.5%的患者获得治疗结束时病毒学应答（1型或4型为基因型的患者中占39.1%；3型为基因型的患者中占73.4%），54.7%的患者获得持续病毒学应答（1型或4型为基因型的患者中占34.8%；3型为基因型的患者中占70.0%）。有19名（35.8%）退出者和3名（5.7%）无应答者：1名1型基因型和2名4型基因型。2名（3.8%）患者复发：1型和3型基因型。治疗期分析显示，在完成前12周治疗的43名受试者中，40名（93.1%）以及在完成前24周治疗的35名受试者中，HCV-RNA呈阴性。除1名3型基因型感染患者外，所有获得治疗结束时应答的受试者均获得持续应答。
我们的数据表明，在多学科标准化管理模式下进行抗病毒治疗有助于许多HCV阳性吸毒成瘾者获得良好的病毒学应答。
