Marco Mouriño Andrés, da Silva Morán Antonio, Ortiz Seuma Jordi, Solé Carbó Concepció, Roget Alemany Mercè, Sarriera Gracia Carmen, Teixidó Pérez Núria, Robres Guillén Pilar, Guerrero Moreno Rafael Alonso
Servicios Médicos Penitenciarios, La Modelo, Barcelona.
Rev Esp Salud Publica. 2010 Jul-Aug;84(4):423-31.
Drug addiction is not a contraindication to indicate treatment of chronic hepatitis C (CHC), but it has been observed that consumers are more abandon. To study the clinical outcome of hepatitis C treatment in inmate patients with a history in injecting drugs and to analyze which were the causes of abandon.
A multicenter retrospective clinical trial including 162 inmate patients that underwent HCV therapy with pegylated interpheron and ribavirin between January 2003 and January 2008 was performed. It was found in medical history who completed treatment. We used a questionnaire to determine variables associated with discontinuation of treatment and multivariate analysis was performed using logistic regression to identify predictors.
82.7% were intravenous drug users, 21.7% had HIV coinfection and 20.5% were on methadone maintenance therapy. 91.4% completed the whole treatment; 33.1% admitted heroin and/or cocaine consumption during therapy and 7.9% admitted needle and syringe-sharing. Relapse in intravenous consumption in or out of prison was the only one predictive factor of treatment interruption (OR: 10.39, IC: 1.93-55.88; p = 0.006).
Only 9,6% of patients discontinued treatment. Drug use was the main cause of discontinuation of treatment. We recommend the treatment of drug addiction to reduce the discontinuations of treatment for chronic hepatitis C.
药物成瘾并非慢性丙型肝炎（CHC）治疗的禁忌证，但据观察，吸毒者更易中断治疗。本研究旨在探讨有注射吸毒史的囚犯患者丙型肝炎治疗的临床结局，并分析治疗中断的原因。
开展一项多中心回顾性临床试验，纳入2003年1月至2008年1月期间接受聚乙二醇干扰素和利巴韦林治疗丙型肝炎病毒（HCV）的162名囚犯患者。从病历中查找完成治疗的患者。我们使用问卷确定与治疗中断相关的变量，并采用逻辑回归进行多因素分析以确定预测因素。
82.7%为静脉吸毒者，21.7%合并感染人类免疫缺陷病毒（HIV），20.5%接受美沙酮维持治疗。91.4%完成了整个治疗；33.1%在治疗期间承认使用海洛因和/或可卡因，7.9%承认共用针头和注射器。无论在狱中还是出狱后静脉吸毒复发是治疗中断的唯一预测因素（比值比：10.39，95%置信区间：1.93 - 55.88；p = 0.006）。
仅9.6%的患者中断治疗。吸毒是治疗中断的主要原因。我们建议治疗药物成瘾以减少慢性丙型肝炎治疗的中断。
