Alavi M, Micallef M, Fortier E, Dunlop A J, Balcomb A C, Day C A, Treloar C, Bath N, Haber P S, Dore G J, Grebely J
The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
Université de Montréal, Montréal, QC, Canada.
J Viral Hepat. 2015 Nov;22(11):914-25. doi: 10.1111/jvh.12415. Epub 2015 May 21.
Among people who inject drugs (PWID) with chronic HCV, the association between HCV treatment willingness and intent, and HCV specialist assessment and treatment were evaluated. The Enhancing Treatment for Hepatitis C in Opioid Substitution Settings (ETHOS) is a prospective observational cohort. Recruitment was through six opioid substitution treatment clinics, two community health centres and one Aboriginal community controlled health organisation in Australia. Analyses were performed using logistic regression. Among 415 participants (mean age 41 years, 71% male), 67% were 'definitely willing' to receive HCV treatment and 70% reported plans to initiate therapy 12 months postenrolment. Those definitely willing to receive HCV treatment were more likely to undergo specialist assessment (64% vs 32%, P < 0.001) and initiate therapy (36% vs 9%, P < 0.001), compared to those with lower treatment willingness. Those with early HCV treatment plans were more likely to undergo specialist assessment (65% vs 27%, P < 0.001) and initiate therapy (36% vs 5%, P < 0.001), compared to those without early plans. In adjusted analyses, HCV treatment willingness independently predicted specialist assessment (aOR 3.06, 95% CI 1.90, 4.94) and treatment uptake (aOR 4.33, 95% CI 2.14, 8.76). In adjusted analysis, having early HCV treatment plans independently predicted specialist assessment (aOR 4.38, 95% CI 2.63, 7.29) and treatment uptake (aOR 9.79, 95% CI 3.70, 25.93). HCV treatment willingness was high and predicted specialist assessment and treatment. Strategies for enhanced HCV care should be developed with an initial focus on people willing to receive treatment and to increase treatment willingness among those less willing.
在慢性丙型肝炎病毒（HCV）感染的注射吸毒者（PWID）中，评估了HCV治疗意愿与意向以及HCV专科评估与治疗之间的关联。改善阿片类药物替代治疗环境中的丙型肝炎治疗（ETHOS）是一项前瞻性观察队列研究。招募工作通过澳大利亚的六家阿片类药物替代治疗诊所、两家社区卫生中心和一家原住民社区控制的卫生组织进行。采用逻辑回归进行分析。在415名参与者（平均年龄41岁，71%为男性）中，67%“肯定愿意”接受HCV治疗，70%报告计划在入组12个月后开始治疗。与治疗意愿较低者相比，肯定愿意接受HCV治疗的人更有可能接受专科评估（64%对32%，P<0.001）并开始治疗（36%对9%，P<0.001）。与没有早期治疗计划的人相比，有早期HCV治疗计划的人更有可能接受专科评估（65%对27%，P<0.001）并开始治疗（36%对5%，P<0.001）。在调整分析中，HCV治疗意愿独立预测专科评估（调整后比值比[aOR]3.06，95%置信区间[CI]1.90，4.94）和治疗接受情况（aOR 4.33，95%CI 2.14，8.76）。在调整分析中，有早期HCV治疗计划独立预测专科评估（aOR 4.38，95%CI 2.63，7.29）和治疗接受情况（aOR 9.79，95%CI 3.70，25.93）。HCV治疗意愿较高，且可预测专科评估和治疗。应制定加强HCV护理的策略，最初重点关注愿意接受治疗的人群，并提高意愿较低者的治疗意愿。
