Bakaj Gentiana, Valasiuk Tatsiana, Prabhukhot Rupali, Siraj Dawd
Department of Internal Medicine and Infectious Diseases, East Carolina University/Pitt County Memorial Hospital, Greenville, NC 27834, USA.
South Med J. 2012 Oct;105(10):500-3. doi: 10.1097/SMJ.0b013e3182675d86.
The rate of treatment of hepatitis C virus (HCV) infection in human immunodeficiency virus-hepatitis C virus (HIV-HCV) co-infected patients remains historically low. We undertook a retrospective study to review our treatment rate and factors that have negatively influenced this rate. In those treated, we reviewed outcomes and compared results with prior studies.
A total of 233 patients infected with HIV and HCV were followed for 7 years in the infectious diseases (ID) clinic of East Carolina University. Proper follow-up evaluation was determined based on the presence of HCV polymerase chain reaction viral load and genotype testing. The number of patients treated, response to treatment, and reason for no treatment were determined by chart review.
Of 233 patients with positive HCV serology, 48 were excluded due to undetectable HCV viral load. Of the remaining 185 patients, 142 (77%) were evaluated by testing for HCV viral load and genotype, but only 112 of those who were followed up in the clinic regularly were considered eligible for therapy. Fourteen of 112 (12.5%) of patients underwent treatment and only 1 in 14 (7%) attained sustained virological response (SVR). Of the patients tested, 96% had HCV genotype 1, and 81% were African American.
The majority of our HIV-HCV co-infected patients received a proper HCV evaluation, but only 12.5% were offered therapy. Of those treated, only one patient achieved SVR. The higher proportion of genotype 1 and African American patient population are considered the main reasons for the low SVR. Low SVR rate, high rate of adverse effects, and the unique demography of our patient population have been the main reasons for the lower treatment rate.
在人类免疫缺陷病毒 - 丙型肝炎病毒（HIV - HCV）合并感染患者中，丙型肝炎病毒（HCV）感染的治疗率历来较低。我们进行了一项回顾性研究，以审查我们的治疗率以及对该率产生负面影响的因素。对于接受治疗的患者，我们审查了治疗结果并与先前的研究结果进行比较。
东卡罗来纳大学传染病诊所对总共233例感染HIV和HCV的患者进行了7年的随访。根据HCV聚合酶链反应病毒载量和基因型检测情况确定适当的随访评估。通过病历审查确定接受治疗的患者数量、治疗反应以及未治疗的原因。
在233例HCV血清学阳性患者中，48例因HCV病毒载量检测不到而被排除。在其余185例患者中，142例（77%）通过检测HCV病毒载量和基因型进行了评估，但在诊所定期随访的患者中，只有112例被认为符合治疗条件。112例患者中有14例（12.5%）接受了治疗，其中只有1例（7%）获得了持续病毒学应答（SVR）。在接受检测的患者中，96%为HCV 1型，81%为非裔美国人。
我们大多数HIV - HCV合并感染患者接受了适当的HCV评估，但只有12.5%的患者接受了治疗。在接受治疗的患者中，只有1例实现了SVR。1型基因型患者和非裔美国人患者比例较高被认为是SVR较低的主要原因。SVR率低、不良反应发生率高以及我们患者群体独特的人口统计学特征是治疗率较低的主要原因。
