Service d'hépatologie, Université Pierre et Marie Curie Liver Center, Hôpital La Pitié Salpêtrière, 75013 Paris, France.
Gastroenterol Res Pract. 2010;2010. doi: 10.1155/2010/261472. Epub 2010 Jul 18.
Barriers to management of HCV in injection drug users are related to patients, health providers, and facilities. In a primary care drug user's addiction centre we studied access to HCV standard of care before and after using an onsite total care concept provided by a multidisciplinary team and noninvasive liver fibrosis evaluation. A total of 586 patients were seen between 2002 and 2004. The majority, 417 patients, were HCV positive and of these patients 337 were tested positive for HCV RNA. In 2002, patients were sent to the hospital. with the Starting of 2003, patients were offered standard of care HCV management in the center by a team of general practitioners, a consultant hepatologist, psychiatrists, nurses, and a health counsellor. Liver fibrosis was assessed by a non invasive method. In 2002, 6 patients had liver fibrosis assessment at hospital facilities, 4 patients were assessed with liver biopsy and 2 patients with Fibrotest-Actitest. 2 patients were treated for HCV at hospital. In 2003 and 2004, 224 patients were assessed with Fibrotest-Actitest on site. Of these, 85 were treated for HCV. SVR was achieved in 43%. We conclude that the combination of an onsite multidisciplinary team with the use of a noninvasive assessment method led to improved management of HCV infection in drug users' primary care facility.
在注射吸毒者中，HCV 管理的障碍与患者、医疗服务提供者和医疗机构有关。在我们研究的一家基层医疗吸毒者成瘾中心，在使用多学科团队提供的现场全面护理概念和非侵入性肝纤维化评估前后，我们研究了 HCV 标准护理的可及性。2002 年至 2004 年间共诊治了 586 名患者。大多数（417 名）患者 HCV 阳性，其中 337 名 HCV RNA 检测阳性。2002 年，患者被送往医院。从 2003 年开始，患者在中心接受由全科医生、顾问肝病专家、精神科医生、护士和健康顾问组成的团队提供的 HCV 标准护理管理。通过非侵入性方法评估肝纤维化。2002 年，6 名患者在医院设施进行了肝纤维化评估，4 名患者进行了肝活检，2 名患者进行了 Fibrotest-Actitest。2 名患者在医院接受了 HCV 治疗。2003 年和 2004 年，224 名患者在现场进行了 Fibrotest-Actitest 评估。其中，85 人接受了 HCV 治疗。SVR 达到了 43%。我们的结论是，现场多学科团队与非侵入性评估方法的结合，改善了基层医疗吸毒者护理设施中 HCV 感染的管理。
