Li Li, Lin Chunqing, Liang Li-Jung, Pham Quang Loc, Feng Nan, Nguyen Anh Tuan
Semel Institute for Neuroscience and Human Behavior - Center for Community Health, the University of California, Los Angeles, CA, USA.
National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
AIDS Care. 2020 May;32(sup2):83-90. doi: 10.1080/09540121.2020.1739209.
HCV co-infection is widespread among people living with HIV who use drugs (PLHWUD). However, HCV testing was inconsistently implemented among PLHWUD. The low infection awareness and mental health challenges together impede PLHWUD's treatment-seeking. The study used baseline data of a randomized controlled trial conducted in Vietnam. HCV infection status was collected through self-report and medical record review. A linear mixed-effects regression model was used to examine the relationships between PLHWUD's perceived barriers to seeking healthcare, their depressive symptoms, and the consistencies in HCV status reports. Among the 181 PLHWUD in the study, one-third (64; 35.4%) had inconsistent self-reports and medical records of HIV infection status. The agreement between the two records was fair (Kappa statistics = 0.43). PLHWUD with consistent HCV infection confirmed by both medical records and self-reports perceived lower levels of healthcare-seeking barriers than those with discrepant HCV reports (estimated difference = -1.59, SE = 0.71, = 0.027). Depressive symptoms were significantly correlated with healthcare-seeking barriers among those with discrepant HCV results (estimate = 0.17, SE = 0.06, = 0.007). There is an urgent need to extend HCV screening efforts and increase HCV awareness among PLHWUD. Explicit HCV result notification and integrated mental health support are recommended to facilitate patients' access to needed care.
丙型肝炎病毒（HCV）合并感染在使用毒品的艾滋病毒感染者（PLHWUD）中广泛存在。然而，HCV检测在PLHWUD中实施情况并不一致。感染意识低和心理健康问题共同阻碍了PLHWUD寻求治疗。该研究使用了在越南进行的一项随机对照试验的基线数据。通过自我报告和病历审查收集HCV感染状况。使用线性混合效应回归模型来检验PLHWUD寻求医疗保健的感知障碍、他们的抑郁症状以及HCV状况报告的一致性之间的关系。在该研究的181名PLHWUD中，三分之一（64名；35.4%）的艾滋病毒感染状况自我报告和病历不一致。两份记录之间的一致性一般（卡方统计量=0.43）。病历和自我报告均确认HCV感染一致的PLHWUD比HCV报告不一致的PLHWUD感知到的寻求医疗保健障碍水平更低（估计差异=-1.59，标准误=0.71，P=0.027）。在HCV结果不一致的人群中，抑郁症状与寻求医疗保健障碍显著相关（估计值=0.17，标准误=0.06，P=0.007）。迫切需要扩大HCV筛查力度并提高PLHWUD对HCV的认识。建议明确HCV结果通知并提供综合心理健康支持，以促进患者获得所需护理。
