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8 周 Glecaprevir/Pibrentasvir 治疗被监禁的 HCV 病毒血症患者的可行性和疗效:一项病例对照研究。

Feasibility and efficacy of 8 week Glecaprevir/Pibrentasvir to treat incarcerated viraemic HCV patients: A case-control study.

机构信息

Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.

Penitentiary Infectious Diseases Unit, A.O. Santi Paolo e Carlo, University of Milan, Milan, Italy.

出版信息

Liver Int. 2021 Feb;41(2):271-275. doi: 10.1111/liv.14745. Epub 2020 Dec 2.

Abstract

Inmates have higher HCV prevalence than general population, representing a fundamental step towards HCV eradication. Our aim was to compare 8-week glecaprevir/pibrentasvir treatment in a case-control study between incarcerated and free patients. Eleven Italian prisons and six outpatient clinics were involved. Patients were matched for sex, risk factors, METAVIR grade, HIV and HBV co-infections. About 131 incarcerated (Group A) and 131 free patients (Group B) were included. Mean age was 43.0 ± 9.6 years and 42.8 ± 9.9 in Group A and B, respectively (P = .74). SVR rates were 96.2% and 99.2% in Group A and Group B respectively (P = .21). Five drop-outs occurred in Group A, one in Group B. Incarceration, being PWIDs and OST were not associated with SVR reductions (CI 95%). In conclusion, imprisonment does not influence unplanned interruptions or SVR rates when receiving short-term therapies. Short schedules with pangenotypic regimens could be a good approach to hard-to-reach populations, such as incarcerated patients.

摘要

囚犯的 HCV 感染率高于一般人群,这是朝着 HCV 消除迈出的重要一步。我们的目的是在一项病例对照研究中比较在监禁和非监禁患者中使用 8 周 glecaprevir/pibrentasvir 的治疗效果。有 11 家意大利监狱和 6 家门诊参与了该研究。根据性别、风险因素、METAVIR 分级、HIV 和 HBV 合并感染对患者进行匹配。共纳入 131 名监禁(A 组)和 131 名非监禁(B 组)患者。A 组和 B 组的平均年龄分别为 43.0±9.6 岁和 42.8±9.9 岁(P=0.74)。A 组和 B 组的 SVR 率分别为 96.2%和 99.2%(P=0.21)。A 组有 5 例脱落,B 组有 1 例脱落。监禁、注射吸毒者和阿片类药物替代治疗与 SVR 降低无关(95%CI)。总之,在接受短期治疗时,监禁不会影响无计划中断或 SVR 率。使用泛基因型方案的短期方案可能是一种针对难以接触到的人群(如监禁患者)的良好方法。

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