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在一家私人诊所,丙型肝炎综合治疗与改善阿片类药物使用障碍门诊治疗的留存率及成功率相关。

Integrated hepatitis C treatment is associated with improved retention and success in outpatient treatment for opioid use disorder at a private clinic.

作者信息

Losikoff Phyllis, Bosse Jordon D, Martin Stephen A, Wilson Amanda, Chiodo Lisa M

机构信息

CleanSlate Outpatient Addiction Medicine, New Bedford, MA, United States.

Division of Pediatric Infectious Disease, The Warren Alpert Medical School of Brown University, Providence, RI, United States.

出版信息

Front Psychiatry. 2022 Sep 14;13:932306. doi: 10.3389/fpsyt.2022.932306. eCollection 2022.

DOI:10.3389/fpsyt.2022.932306
PMID:36186876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9515307/
Abstract

BACKGROUND

Direct acting antiretrovirals (DAA) are effective for individuals who are infected with chronic hepatitis C virus (HCV), yet many people go without access to these lifesaving treatments.

MATERIALS AND METHODS

We conducted a non-randomized study evaluating treatment data for patients in outpatient treatment for opioid use disorder (OUD) at a private clinic. Patients who were HCV-positive, had been in OUD treatment for at least 4 weeks, and engaged in integrated HCV treatment with DAA (co-located within their treatment for OUD) were compared to patients with HCV who only received OUD treatment. We evaluated HCV cure; OUD medication adherence, treatment utilization and retention; and illicit substance use for those engaged in treatment between 9/2016 and 1/2018.

RESULTS

Seventy-four patients completed integrated HCV-OUD treatment with DAA, with 87.8% achieving cure. Of the 66 who completed treatment and were subsequently evaluated for sustained viral response 98.5% were cured. Patients who received integrated HCV and OUD treatment in our clinic, stayed in OUD treatment longer, demonstrated higher OUD medication adherence, and used less opioids or cocaine compared to HCV-infected patients ( = 572) being treated only for OUD.

DISCUSSION

We have reported on a reproducible intervention that lends itself to outpatient OUD treatment. Analyses demonstrate the potential positive impact HCV treatment has on OUD recovery, including reduction in opioid and cocaine use and increased retention in care.

CONCLUSION

Co-locating HCV treatment with existing OUD treatment is feasible, effective, and demonstrates positive outcomes for the treatment of both conditions.

摘要

背景

直接作用抗病毒药物(DAA)对慢性丙型肝炎病毒(HCV)感染者有效,但许多人无法获得这些挽救生命的治疗方法。

材料与方法

我们进行了一项非随机研究,评估一家私人诊所中接受阿片类药物使用障碍(OUD)门诊治疗患者的治疗数据。将HCV呈阳性、接受OUD治疗至少4周且接受DAA联合HCV治疗(与OUD治疗在同一地点)的患者与仅接受OUD治疗的HCV患者进行比较。我们评估了HCV治愈情况;OUD药物依从性、治疗利用率和留存率;以及2016年9月至2018年1月期间接受治疗者的非法药物使用情况。

结果

74名患者完成了DAA联合HCV - OUD治疗,87.8%实现治愈。在完成治疗并随后接受持续病毒学应答评估的66名患者中,98.5%治愈。与仅接受OUD治疗的HCV感染患者(n = 572)相比,在我们诊所接受HCV和OUD联合治疗的患者在OUD治疗中停留时间更长,OUD药物依从性更高,使用的阿片类药物或可卡因更少。

讨论

我们报告了一种可重复的干预措施,适用于门诊OUD治疗。分析表明HCV治疗对OUD康复具有潜在的积极影响,包括减少阿片类药物和可卡因使用以及提高护理留存率。

结论

将HCV治疗与现有的OUD治疗安排在同一地点是可行、有效的,并且对两种疾病的治疗都显示出积极效果。

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Integrated hepatitis C treatment is associated with improved retention and success in outpatient treatment for opioid use disorder at a private clinic.在一家私人诊所,丙型肝炎综合治疗与改善阿片类药物使用障碍门诊治疗的留存率及成功率相关。
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Modeling Combination Hepatitis C Virus Treatment and Prevention Strategies in a Network of People Who Inject Drugs in the United States.在美国的注射吸毒者网络中对丙型肝炎病毒治疗和预防策略进行建模。
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Hepatitis C Guidance 2019 Update: American Association for the Study of Liver Diseases-Infectious Diseases Society of America Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection.
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Drug Alcohol Depend. 2024 Oct 1;263:112410. doi: 10.1016/j.drugalcdep.2024.112410. Epub 2024 Aug 12.
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Care Integration for Hepatitis C Virus Treatment Through Facilitated Telemedicine Within Opioid Treatment Programs: Qualitative Study.通过在阿片类药物治疗计划中实施便利的远程医疗实现丙型肝炎病毒治疗的护理整合:定性研究。
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《2019年丙型肝炎指南更新:美国肝病研究协会-美国传染病学会关于丙型肝炎病毒感染检测、管理及治疗的建议》
Hepatology. 2020 Feb;71(2):686-721. doi: 10.1002/hep.31060.
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