Epidemiol Mikrobiol Imunol. 2021 Spring;70(1):18-25.
Long-term monitoring of the mutual effects of chronic viral hepatitis C (VHC) treatment and tailored addiction treatment. In 2016, the World Health Organization (WHO) published an action plan to eliminate viral hepatitis C globally by 2030. People who inject drugs (PWID) are a key population that needs increased attention and care. Two decades before the announcement of the WHO plan for the global elimination of HCV (hepatitis C virus), the Remedis Medical Facility, where the study was conducted, established a “Comprehensive Care Program for patients with substance use disorders and addictive behaviour”.
We evaluated all patients who were in the methadone program as of 1 March 2020, regardless of OST duration, OST dosage, age or gender. Their epidemiological and demographic data obtained during a structured clinical interview and laboratory test results were analysed.
Of 24 patients on methadone substitution therapy, 12 (50%) were anti-HCV negative before starting OST. None of them became newly infected with hepatitis C virus (HCV) during OST. The remaining 12 of the study patients were anti-HCV positive. Ten of them have already undergone successful treatment for viral hepatitis. Two patients were re-infected with HCV.
The presented work confirms the high efficacy of chronic VHC treatment among PWID in inducing suitable conditions. We consider combination of HCV infection treatment and targeted tailored addiction treatment as a starting point for achieving control over the HCV epidemic in the Czech Republic, with a possible positive impact on other blood-borne infections related to risky behaviour.
长期监测慢性丙型肝炎（VHC）治疗与针对性成瘾治疗的相互影响。2016 年，世界卫生组织（WHO）发布了一项行动计划，计划到 2030 年在全球消除丙型肝炎病毒。注射毒品者（PWID）是一个需要更多关注和关怀的关键人群。在 WHO 宣布全球消除 HCV（丙型肝炎病毒）计划的 20 年前，该研究所在的 Remedis 医疗设施就已经建立了“物质使用障碍和成瘾行为患者综合护理计划”。
我们评估了截至 2020 年 3 月 1 日所有参加美沙酮维持治疗计划的患者，无论 OST 持续时间、OST 剂量、年龄或性别如何。对他们在结构化临床访谈和实验室检测结果中获得的流行病学和人口统计学数据进行了分析。
在 24 名接受美沙酮替代治疗的患者中，有 12 名（50%）在开始 OST 前抗-HCV 阴性。在 OST 期间，他们均未感染新的丙型肝炎病毒（HCV）。研究中的其余 12 名患者抗-HCV 阳性。其中 10 人已成功接受了病毒性肝炎的治疗。2 人再次感染了 HCV。
本研究证实，在 PWID 中，慢性 VHC 治疗在诱导适当条件方面具有很高的疗效。我们认为 HCV 感染治疗与针对性成瘾治疗相结合是控制捷克共和国 HCV 流行的起点，这可能对与危险行为相关的其他血液传播感染产生积极影响。
