Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
Dig Dis Sci. 2011 May;56(5):1509-15. doi: 10.1007/s10620-011-1604-3. Epub 2011 Feb 19.
Response to current therapy of hepatitis C virus (HCV) is suboptimal. Direct-acting antiviral therapies (DAA) are expected to improve treatment outcomes. Additional treatments for HCV will invariably make therapeutic choices and patient management more complex. We hypothesize that current perceptions regarding the complexity of DAA therapy will influence attitudes towards future use by practitioners who are currently treating HCV.
An Internet-based survey was sent to 10,082 AASLD and AGA members to determine if they treat HCV infection, their knowledge of DAA therapies, attitudes towards current and future HCV treatments, and if they participated in clinical trials using DAA agents.
Out of a total of 1,757 individuals responding to the survey, 75% treat HCV; 79% were MDs, 67% were Gastroenterologists, and 24% were Hepatologists. Of the respondents, 77% indicated they were "very aware" or "aware" of DAA therapies, 20% participated in clinical trials, and 3% had minimal knowledge of DAA agents. Comparing treatment "today" versus in the future when DAAs were available, 85 vs. 81% would treat (p = 0.0054), 6 vs. 10% would refer to an "HCV expert" (p = 0.016), and 1% would refer to an ID specialist. Of respondents with "minimal knowledge" of DAA, 52% stated that they would use them in the future.
Although the majority of respondents appear ready to utilize DAA agents in the future, referrals to "hepatitis C experts" will increase. More than half of respondents with "minimal knowledge" of DAA therapies also appear to be willing to utilize these compounds, raising concerns regarding their inappropriate use. Broad education of healthcare providers to prevent inappropriate use of these agents will be critical.
目前对丙型肝炎病毒 (HCV) 的治疗效果并不理想。直接作用的抗病毒治疗 (DAA) 有望改善治疗效果。HCV 的额外治疗将不可避免地使治疗选择和患者管理更加复杂。我们假设，目前对 DAA 治疗复杂性的看法将影响目前正在治疗 HCV 的从业者对未来使用的态度。
我们向 AASLD 和 AGA 的 10082 名成员发送了一项基于互联网的调查，以确定他们是否治疗 HCV 感染，他们对 DAA 治疗的了解，对当前和未来 HCV 治疗的态度，以及他们是否参与了使用 DAA 药物的临床试验。
在总共回复调查的 1757 个人中，75%的人治疗 HCV；79%是 MD，67%是胃肠病学家，24%是肝病学家。在受访者中，77%的人表示他们“非常了解”或“了解”DAA 治疗，20%的人参与了临床试验，3%的人对 DAA 药物知之甚少。与今天治疗 HCV 相比，当 DAA 可用时，85%vs.81%的人会治疗（p = 0.0054），6%vs.10%的人会推荐给“HCV 专家”（p = 0.016），1%的人会推荐给 ID 专家。对于对 DAA 知之甚少的受访者，52%的人表示将来会使用它们。
尽管大多数受访者似乎准备在未来使用 DAA 药物，但对“丙型肝炎专家”的推荐将会增加。超过一半对 DAA 治疗知之甚少的受访者似乎也愿意使用这些化合物，这引起了人们对其不当使用的担忧。广泛教育医疗保健提供者以防止这些药物的不当使用将是至关重要的。
