感染 HIV/HCV 合并感染的患者接受 HCV 治疗的时间不利：来自大型城市三级中心的研究结果。
Time to HCV Treatment Disfavors Patients Living with HIV/HCV Co-infection: Findings from a Large Urban Tertiary Center.
机构信息
Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
出版信息
J Racial Ethn Health Disparities. 2022 Oct;9(5):1662-1669. doi: 10.1007/s40615-021-01105-5. Epub 2021 Jul 12.
This study aimed to assess time to hepatitis C (HCV) treatment (i.e., the time between the initial clinic visit for HCV evaluation and the HCV treatment start date), to compare clinical characteristics between patients who received HCV treatment ≥ and < 6 months, and to identify predictors of longer time to HCV treatment in patients living with HCV. This study conducted a retrospective secondary analysis of patients living with HCV mono-infection and HIV/HCV co-infection who received HCV treatment with DAAs (n=214) at a HIV Clinic. Binomial logistic regression was used to identify predictors of longer time to treatment (i.e., ≥ 6 months). The median time to HCV treatment was 211 days. Compared to patients who were treated < 6 months, a higher proportion of patients who were treated ≥ 6 months had HIV/HCV co-infection (31% vs. 49%, p=0.01) and chronic kidney disease (8% vs. 18%, p=0.03). In multivariate analysis, HIV/HCV co-infection was positively associated with a longer time to HCV treatment (adjusted odds ratio, aOR=2.0, p=0.03). Time to HCV treatment disparities between African American and White American did not emerge from the analysis, but time to HCV treatment disfavored patients living with HIV/HCV co-infection. Studies are needed to identify and eliminate factors that disfavor patients living with HIV/HCV co-infection.
本研究旨在评估丙型肝炎（HCV）治疗的时间（即 HCV 评估初始就诊到 HCV 治疗开始日期之间的时间），比较接受 HCV 治疗≥6 个月和 < 6 个月的患者的临床特征，并确定影响 HCV 患者治疗时间的因素。本研究对在 HIV 诊所接受直接作用抗病毒药物（DAAs）治疗的 HCV 单感染和 HIV/HCV 共感染患者进行了 HCV 治疗时间的回顾性二次分析（n=214）。二项逻辑回归用于确定治疗时间较长（即≥6 个月）的预测因素。HCV 治疗的中位时间为 211 天。与治疗时间 < 6 个月的患者相比，治疗时间≥6 个月的患者中 HIV/HCV 共感染（31%比 49%，p=0.01）和慢性肾脏病（8%比 18%，p=0.03）的比例更高。多变量分析显示，HIV/HCV 共感染与 HCV 治疗时间较长呈正相关（调整优势比，aOR=2.0，p=0.03）。本研究未发现非裔美国人和白人美国 HCV 治疗时间存在差异，但 HIV/HCV 共感染患者的 HCV 治疗时间不利。需要开展研究以确定并消除不利于 HIV/HCV 共感染患者的因素。
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