Allyn P R, O'Malley S M, Ferguson J, Tseng C H, Chew K W, Bhattacharya D
1 Division of Infectious Diseases, Department of Medicine, 12222 University of California Los Angeles , Los Angeles, CA, USA.
2 UCLA Center for Clinical AIDS Research and Education (CARE), Los Angeles, CA, USA.
Int J STD AIDS. 2018 Mar;29(4):334-340. doi: 10.1177/0956462417725462. Epub 2017 Aug 18.
This study aimed to assess attitudes and potential barriers towards treatment in patients with hepatitis C virus (HCV) infection, comparing those with and without HIV coinfection. A cross-sectional survey of 82 HCV-infected adults with and without HIV was conducted in greater Los Angeles between November 2013 and July 2015. Overall, there were 53 (64.6%) with HIV coinfection, 20 (25.0%) with self-reported cirrhosis, and 22 (26.8%) with a history of prior HCV treatment. Of all, 93.2% wanted HCV treatment, but 45.9% were unwilling/unable to spend anything out of pocket, 29.4% were waiting for new therapies, and 23.5% were recommended to defer HCV treatment. HIV/HCV-coinfected patients were more likely to want treatment within one year (90.2% versus 68.2%, p = 0.02), more willing to join a clinical trial (74.5% versus 8.0%, p < 0.01), more willing to take medications twice daily (86.3% versus 61.5%, p = 0.01), and more likely to prefer hepatitis C treatment by an infectious diseases/HIV physician (36.7% versus 4.0%, p < 0.01). Of all, 77.1% of coinfected patients were willing to change antiretroviral therapy if necessary to treat HCV, but only 48.0% of patients were willing to take a medication if it had not been studied in HIV-positive patients. Treatment preferences differ between HIV/HCV-coinfected and HCV-monoinfected patients. Despite a strong willingness among the study cohort to start HCV treatment, other factors such as cost, access to medications, and provider reluctance may be delaying treatment initiation.
本研究旨在评估丙型肝炎病毒（HCV）感染患者对治疗的态度和潜在障碍，并比较合并或未合并人类免疫缺陷病毒（HIV）感染的患者。2013年11月至2015年7月期间，在大洛杉矶地区对82名合并或未合并HIV感染的HCV感染成人进行了一项横断面调查。总体而言，有53例（64.6%）合并HIV感染，20例（25.0%）自述有肝硬化，22例（26.8%）有既往HCV治疗史。其中，93.2%的患者希望接受HCV治疗，但45.9%的患者不愿意/无能力自掏腰包支付任何费用，29.4%的患者在等待新疗法，23.5%的患者被建议推迟HCV治疗。合并HIV/HCV感染的患者更有可能在一年内希望接受治疗（90.2%对68.2%，p = 0.02），更愿意参加临床试验（74.5%对8.0%，p < 0.01），更愿意每天服用两次药物（86.3%对61.5%，p = 0.01），并且更有可能倾向于由传染病/HIV医生进行丙型肝炎治疗（36.7%对4.0%，p < 0.01）。其中，77.1%的合并感染患者愿意在必要时改变抗逆转录病毒疗法以治疗HCV，但只有48.0%的患者愿意服用尚未在HIV阳性患者中进行研究的药物。合并HIV/HCV感染的患者和单纯HCV感染的患者在治疗偏好上存在差异。尽管研究队列中强烈希望开始HCV治疗，但成本、药物可及性和医疗服务提供者的顾虑等其他因素可能会延迟治疗的开始。
