From the U.O. SERT D.S. 31 ASL Napoli 1 Centro (FC, CC, GD, FF, MG, AL, SMasucci, MP, CV, GV, GDR), P.O. Gesù e Maria; D.A.I. Malattie Infettive e Medicina Interna S.U.N. (FDM, FB, NC, AC, SMartini, GP, RP, PF); and U.O. Salute Mentale D.S.B. 51 ASL Napoli 1 Centro (FA, AM, MR), P.O. Gesù e Maria, Napoli, Italy.
J Addict Med. 2010 Dec;4(4):223-32. doi: 10.1097/ADM.0b013e3181cae4d0.
Hepatitis C Virus (HCV) infection is treated with peg-interferon α2a or α2b and ribavirin. International studies show that drug user adherence to treatment is 40% to 60% and increases if the patient is in addiction treatment. The aim of the Together To Take Care (TTTC) study was to achieve better adherence to HCV therapy in randomly selected drug users, who are considered "difficult to treat." The secondary aim of the TTTC Study Group was to standardize a method for a multidisciplinary management of the liver disease in drug users. The TTTC group data were matched with a control group. Adherence: The 93.7% of patients followed therapy prescribed; of the patients infected by HCV genotype (gt) 3, all completed therapy as scheduled. For the 48-week treatment group, 66.7% of patients completed therapy (2 of 9 patients stopped treatment for breakthrough). Toxicological results: 10 (62.5%) patients were negative in the toxicological tests (opiates, cocaine, and alcohol). Virological results: 8 of 16 patients were infected by HCV gt 1, and 8 were infected by gt 3; 2 of 16 (12.5%) patients were human immunodeficiency virus (HIV) coinfected (1 HCV gt 1a and 1 HCV gt 3). All patients: 11 of 16 (68.75%) patients were HCV ribonucleic acid undetectable 24 weeks after completing therapy (sustained virological response, SVR). Gt 1: 4 of 8 (50.0%) showed SVR. Gt 3: 7 of 8 (87.5%) showed SVR. Overall, the HCV gt 3 patients had 87.5% probability of SVR, whereas gt 1 patients had 50% probability of SVR (gt 3/gt 1 patients odds ratio = 7). The results were analyzed by Fisher exact test. Our results show that good healthcare management plays an important role in increasing patients' adherence to therapy. In the project "TTTC," the patients work with the physicians to take responsibility for their health and acquire self-efficacy and self-awareness, thanks to the special care.
丙型肝炎病毒 (HCV) 感染的治疗方法是使用聚乙二醇干扰素 α2a 或 α2b 和利巴韦林。国际研究表明，药物使用者对治疗的依从性为 40%至 60%，如果患者正在接受戒毒治疗，依从性会提高。“共同照顾”（TTTC）研究的目的是提高随机选择的药物使用者对 HCV 治疗的依从性，这些人被认为是“难以治疗”的。TTTC 研究小组的次要目标是为药物使用者的肝病多学科管理制定标准化方法。TTTC 组的数据与对照组相匹配。依从性：93.7%的患者遵循规定的治疗方案；所有感染 HCV 基因型 (gt) 3 的患者均按计划完成治疗。对于 48 周治疗组，66.7%的患者完成治疗（9 名患者中有 2 名因突破性感染停止治疗）。毒理学结果：10 名（62.5%）患者毒理学检测呈阴性（阿片类、可卡因和酒精）。病毒学结果：16 名患者中有 8 名感染 HCV gt 1，8 名感染 HCV gt 3；16 名患者中有 2 名（12.5%）感染人类免疫缺陷病毒 (HIV)（1 名 HCV gt 1a 和 1 名 HCV gt 3）。所有患者：16 名患者中有 11 名（68.75%）在完成治疗后 24 周时 HCV 核糖核酸不可检测（持续病毒学应答，SVR）。gt 1：8 名患者中有 4 名（50.0%）显示 SVR。gt 3：8 名患者中有 7 名（87.5%）显示 SVR。总的来说，HCV gt 3 患者的 SVR 概率为 87.5%，而 gt 1 患者的 SVR 概率为 50%（gt 3/gt 1 患者比值比=7）。Fisher 确切检验分析结果。我们的结果表明，良好的医疗保健管理对提高患者对治疗的依从性起着重要作用。在“TTTC”项目中，患者与医生合作，对自己的健康负责，并通过特殊护理获得自我效能和自我意识。
