Watson Bianca, Conigrave Katherine M, Wallace Cate, Whitfield John B, Wurst Friedrich, Haber Paul S
Royal Prince Alfred Hospital, Sydney, Australia.
Drug Alcohol Rev. 2007 May;26(3):231-9. doi: 10.1080/09595230701247681.
Amongst people on opioid maintenance treatment (OMT), chronic hepatitis C (HCV) is common but infrequently treated. Numerous barriers, including misuse of alcohol may limit efforts at anti-viral treatment. The aim of this study was to define barriers, including alcohol misuse, to the effective treatment of HCV amongst OMT recipients. Ninety-four OMT patients completed the 3-item Alcohol Use Disorders Identification Test (AUDIT-C). A semi-structured interview was used in 53 subjects to assess alcohol use in detail, psychological health, discrimination and access to HCV treatment. Feasibility of brief intervention for alcohol misuse was assessed. Of the screening participants, 73% reported they were HCV positive. Of the detailed interview participants, 26% reported no drinking in the past month, but 53% scored 8 or more on AUDIT and 42% exceeded NHMRC drinking guidelines. Twenty subjects received brief intervention and among 17 re-interviewed at one month, alcohol consumption fell by 3.1 g/day (p = 0.003). Severe or extremely severe depression, stress and anxiety were found in 57%, 51% and 40% of interviewees respectively. Episodic heavy drinking, mental health problems, perceived discrimination, limited knowledge concerning HCV were all common and uptake of HCV treatment was poor. Brief intervention for alcohol use problems was acceptable to OMT patients, and warrants further study.
在接受阿片类药物维持治疗（OMT）的人群中，慢性丙型肝炎（HCV）很常见，但很少得到治疗。包括酗酒在内的众多障碍可能会限制抗病毒治疗的努力。本研究的目的是确定包括酗酒在内的、影响OMT接受者有效治疗HCV的障碍。94名OMT患者完成了3项酒精使用障碍识别测试（AUDIT-C）。对53名受试者进行了半结构化访谈，以详细评估酒精使用情况、心理健康、歧视以及获得HCV治疗的情况。评估了针对酗酒进行简短干预的可行性。在筛查参与者中，73%报告他们HCV呈阳性。在详细访谈参与者中，26%报告在过去一个月没有饮酒，但53%在AUDIT上的得分达到8分或更高，42%超过了澳大利亚国家卫生与医学研究委员会（NHMRC）的饮酒指南。20名受试者接受了简短干预，在17名一个月后接受再次访谈的受试者中，酒精摄入量每天减少了3.1克（p = 0.003）。分别有57%、51%和40%的受访者存在严重或极其严重的抑郁、压力和焦虑。偶尔大量饮酒、心理健康问题、感知到的歧视、对HCV的了解有限都很常见，而且HCV治疗的接受情况较差。针对酒精使用问题的简短干预对OMT患者是可以接受的，值得进一步研究。
