作为丙型肝炎微消除策略的失访 HCV 患者检索：巴西多中心研究的结果。
Retrieval of HCV patients lost to follow-up as a strategy for Hepatitis C Microelimination: results of a Brazilian multicentre study.
机构信息
Federal University of São Paulo, Rua Loefgren 1570, São Paulo, CEP 04040-002, SP, Brazil.
Federal University of Bahia, Salvador, Brazil.
出版信息
BMC Infect Dis. 2023 Jul 13;23(1):468. doi: 10.1186/s12879-023-08169-0.
BACKGROUND
Several HCV patients in Brazil were lost to follow-up (LTFU) in the last two decades before achievement of sustained virological response (SVR). Strategies to recall those diagnosed but untreated patients have been used elsewhere with different success rates.
AIM
To identify and retrieve LTFU patients in order to offer them the treatment with the current highly effective direct acting antiviral agents (DAAs).
METHODS
Registries ofall HCV patients from three large reference centers in Brazil were retrospectively reviewed to identify those with no registry of SVR. Reasons for non-achievement of SVR were elicited in HCV-RNA + patients. All patients who were not treated or cured were contacted to offer the therapy with DAAs.
RESULTS
10,289 HCV patients (50% males, mean age 52 ± 11 years) were identified. Only 4,293 (41.7%) had been successfully treated previously. From the remaining 5,996 most were LTFU (59%), were not treated for other reasons (14.7%) or were non-responders (26.3%). After revision of the charts 3,559 were considered eligible to be retrieved. The callback success of phone calls was 18%, 13% to cellphone messages (SMS or WhatsApp) and 7% to regular mail. Five-hundred sixty patients had been already treatedor were on treatment and 234 were reported to be dead or transplanted. Finally, 201 had made an appointment and initiated antiviral treatment.
CONCLUSION
Even considering the low callback rate, retrieval of LTFU patients was shown to be an important strategy forhepatitis C micro-elimination in Brazil.
背景
在实现持续病毒学应答 (SVR) 之前的过去二十年中，巴西有几位 HCV 患者失访 (LTFU)。在其他地方，已经使用了召回那些被诊断但未接受治疗的患者的策略，但成功率不同。
目的
识别和召回 LTFU 患者，以便为他们提供当前高效的直接作用抗病毒药物 (DAA) 治疗。
方法
回顾性审查了巴西三个大型参考中心的所有 HCV 患者的登记册，以确定那些没有 SVR 登记册的患者。在 HCV-RNA + 患者中，询问未达到 SVR 的原因。联系所有未接受治疗或未治愈的患者，为他们提供 DAA 治疗。
结果
确定了 10,289 名 HCV 患者（50%为男性，平均年龄 52±11 岁）。仅有 4,293 名（41.7%）患者以前成功接受过治疗。在其余 5,996 名患者中，大多数为 LTFU（59%），因其他原因未接受治疗（14.7%）或无应答（26.3%）。在复查病历后，认为有 3,559 名患者符合召回条件。电话呼叫的回拨成功率为 18%，手机短信 (SMS 或 WhatsApp) 为 13%，普通邮件为 7%。已有 560 名患者接受了治疗或正在接受治疗，234 名患者报告死亡或接受了移植。最后，201 名患者已预约并开始抗病毒治疗。
结论
即使考虑到回拨率较低，召回 LTFU 患者仍然是巴西丙型肝炎微消除的重要策略。
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