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某检测中心慢性丙型肝炎现场综合筛查及微消除项目的疗效:监禁患者与门诊患者治疗结果及特征的比较

The Efficacy of On-Site Integration Screening and Microelimination Programs for Chronic Hepatitis C in a Detection Center: A Comparison of the Treatment Outcomes and Characteristics of Incarcerated Patients and Outpatients.

作者信息

Chang Hsuan-Yuan, Wang Su-Hung, Kuo Hsing-Tao, Sheu Ming-Jen, Feng I-Che, Ho Chung-Han, Chen Jui-Yi, Sun Chi-Shu, Chen Chi-Hsing, Lin Cheng-Yi, Yang Chun-Chi

机构信息

Division of Hepatogastroenterology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.

School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.

出版信息

Int J Hepatol. 2024 Mar 13;2024:3184892. doi: 10.1155/2024/3184892. eCollection 2024.

DOI:10.1155/2024/3184892
PMID:38510786
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10954363/
Abstract

We aimed to analyze the different patient characteristics and treatment outcomes (such as sustained viral response, SVR) between incarcerated patients with chronic hepatitis C (CHC) and those with CHC from the outpatient department through an on-site integrated screening and microelimination program in a detection center. In this retrospective study, which ran from May 2021 to April 2022, we included 32 consenting male prisoners aged at least 20 years who were willing to participate in the study. Members of the control group (who received DAAs in an outpatient setting) were selected from the treated CHC patient databank of individuals who received DAA regimens at Chi Mei Hospital between January 2021 and December 2022. The patients in the two groups did not differ significantly in terms of age, FIB-4 score, HCV RNA, HBV coinfection, hemogram findings, coagulation profiles, and renal function tests. However, the patients in the incarcerated group had a significantly different genotype distribution compared to the control group, significantly lower liver enzyme levels, and higher albumin and bilirubin levels compared to those in the control group. The rate of SVR to DAA treatment obtained among incarcerated patients did not differ significantly from that obtained among patients in the control group. Loss to follow-up (for several reasons) is a major reason for treatment discontinuation among these patients.

摘要

我们旨在通过检测中心的现场综合筛查和微消除计划,分析慢性丙型肝炎(CHC)的在押患者与门诊CHC患者之间不同的患者特征和治疗结果(如持续病毒学应答,SVR)。在这项从2021年5月至2022年4月的回顾性研究中,我们纳入了32名年龄至少20岁、同意参与研究的男性囚犯。对照组(在门诊接受直接抗病毒药物治疗的患者)从2021年1月至2022年12月在奇美医院接受直接抗病毒药物治疗方案的CHC患者数据库中选取。两组患者在年龄、FIB-4评分、丙型肝炎病毒核糖核酸、乙型肝炎病毒合并感染、血常规检查结果、凝血指标和肾功能检查方面无显著差异。然而,与对照组相比,在押组患者的基因型分布显著不同,肝酶水平显著较低,白蛋白和胆红素水平高于对照组。在押患者中获得的直接抗病毒药物治疗的持续病毒学应答率与对照组患者中获得的应答率无显著差异。失访(由于多种原因)是这些患者治疗中断的主要原因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a3/10954363/424b68898258/IJH2024-3184892.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a3/10954363/05687db751ec/IJH2024-3184892.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a3/10954363/e86fac8c14ab/IJH2024-3184892.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a3/10954363/424b68898258/IJH2024-3184892.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a3/10954363/05687db751ec/IJH2024-3184892.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a3/10954363/e86fac8c14ab/IJH2024-3184892.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9a3/10954363/424b68898258/IJH2024-3184892.003.jpg

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本文引用的文献

1
Hepatitis C Guidance 2023 Update: AASLD-IDSA Recommendations for Testing, Managing, and Treating Hepatitis C Virus Infection.《2023年丙型肝炎指南更新:美国肝病研究学会-美国感染病学会关于丙型肝炎病毒感染检测、管理及治疗的建议》
Clin Infect Dis. 2023 May 25. doi: 10.1093/cid/ciad319.
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Hepatitis C prevalence in incarcerated settings between 2013-2021: a systematic review and meta-analysis.2013-2021 年监禁环境中丙型肝炎流行率:系统评价和荟萃分析。
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Outreach onsite treatment with a simplified pangenotypic direct-acting anti-viral regimen for hepatitis C virus micro-elimination in a prison.
监狱中丙型肝炎病毒微消除的简化泛基因型直接作用抗病毒治疗方案的现场治疗外展。
World J Gastroenterol. 2022 Jan 14;28(2):263-274. doi: 10.3748/wjg.v28.i2.263.
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Taiwan accelerates its efforts to eliminate hepatitis C.台湾加快消除丙型肝炎的努力。
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Cost-effectiveness of mass screening for Hepatitis C virus among all inmates in an Irish prison.对爱尔兰监狱所有囚犯进行丙型肝炎病毒大规模筛查的成本效益。
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Evaluation of hepatitis C treatment-as-prevention within Australian prisons (SToP-C): a prospective cohort study.澳大利亚监狱内丙型肝炎治疗即预防的评估(SToP-C):一项前瞻性队列研究。
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