Cacoub Patrice, Halfon Philippe, Rosenthal Eric, Pialoux Gilles, Benhamou Yves, Perronne Christian, Pol Stanislas
Université Pierre et Marie Curie-Paris 6, CNRS, UMR 7087, Paris, France.
J Hepatol. 2008 Jan;48(1):35-42. doi: 10.1016/j.jhep.2007.07.028. Epub 2007 Oct 2.
BACKGROUND/AIMS: To analyze the barriers to HCV treatment in HIV-HCV co-infected patients and their evolution between 2004 and 2006.
Three hundred and eighty HIV-HCV co-infected patients were prospectively included in surveys from November 22 to 29, 2004 (2004 survey), and 416 from April 3 to 10, 2006 (2006 survey).
Patients in 2006 compared to those in 2004 had negative HCV RNA more often (24% vs. 12%). The rate of liver biopsy was similar (56% vs. 54%) while 24% had had a non-invasive liver damage assessment. The rate of previous treatment for HCV infection was higher (48% vs. 26%). The main reasons for HCV non-treatment have changed: HCV treatment deemed questionable (44% vs. 53%), lack of liver biopsy (18% vs. 33%), physicians' conviction of poor patient compliance (20% vs. 30%). In both surveys, HCV treated patients were more often of European origin, had better control of HIV infection, and had a liver damage assessment more often.
The care of HIV-HCV co-infected patients has changed significantly in "real life". These results underline the importance of continuing efforts to educate physicians and patients in order to increase the access of co-infected patients to HCV treatment.
背景/目的:分析HIV-HCV合并感染患者接受丙型肝炎病毒(HCV)治疗的障碍及其在2004年至2006年期间的变化。
前瞻性纳入380例HIV-HCV合并感染患者进行2004年11月22日至29日的调查(2004年调查),以及416例患者进行2006年4月3日至10日的调查(2006年调查)。
与2004年的患者相比,2006年的患者HCV RNA阴性更为常见(24%对12%)。肝活检率相似(56%对54%),而24%的患者进行了非侵入性肝损伤评估。既往HCV感染治疗率更高(48%对26%)。HCV未治疗的主要原因发生了变化:认为HCV治疗存疑(44%对53%)、缺乏肝活检(18%对33%)、医生认为患者依从性差(20%对30%)。在两项调查中,接受HCV治疗的患者更多为欧洲血统,HIV感染控制更好,且更常进行肝损伤评估。
在“现实生活”中,HIV-HCV合并感染患者的治疗已发生显著变化。这些结果强调了持续努力对医生和患者进行教育的重要性,以增加合并感染患者获得HCV治疗的机会。