Eckardt Paula, Niu Jianli, Savage Angela, Griffin Tara, Sherman Elizabeth
1 Division of Infectious Diseases, Memorial Physician Group, Hollywood, FL, USA.
2 Office of Human Research, Memorial Healthcare System, Hollywood, FL, USA.
J Int Assoc Provid AIDS Care. 2019 Jan-Dec;18:2325958219835590. doi: 10.1177/2325958219835590.
The high cost of direct-acting antiviral-based regimens raises concerns about the outcome of treatment in uninsured patients with chronic hepatitis C virus (HCV) infection. This study assessed the relationship between health insurance status and sustained virologic response (SVR) rates in a community hospital in South Florida. Sofosbuvir-based therapy was initiated in 82 patients, of which 73% were uninsured and 28 (34%) were HIV coinfection. The overall SVR rate for those tested was 98%. The SVR rates were similar between HCV mono- and HCV/HIV coinfected patients (96% versus 100%, P = .204). Uninsured patients, with access to patient assistance programs, had comparable SVR rates to insured patients (100% versus 95%, P = .131). However, there was a trend toward a higher rate of loss to follow-up in uninsured compared to insured patients (25% versus 9%, P = .116). Strategies specific to adherence to treatment for uninsured patients are needed to reduce rates of loss to follow-up.
基于直接作用抗病毒药物的治疗方案成本高昂，这引发了人们对未参保的慢性丙型肝炎病毒（HCV）感染患者治疗结果的担忧。本研究评估了南佛罗里达州一家社区医院中健康保险状况与持续病毒学应答（SVR）率之间的关系。82例患者开始接受基于索磷布韦的治疗，其中73%未参保，28例（34%）合并感染HIV。接受检测患者的总体SVR率为98%。HCV单感染患者和HCV/HIV合并感染患者的SVR率相似（96%对100%，P = 0.204）。能够获得患者援助计划的未参保患者，其SVR率与参保患者相当（100%对95%，P = 0.131）。然而，与参保患者相比，未参保患者失访率有升高趋势（25%对9%，P = 0.116）。需要采取针对未参保患者坚持治疗的具体策略，以降低失访率。
