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阿片类药物使用障碍患者的丙型肝炎患病率、丙型肝炎病毒知晓情况及某些心理因素

Hepatitis C Prevalence, HCV awareness and Certain Psychological Factors in Patients with Opioid Use Disorder.

作者信息

Dogan Oğuzhan, Olgun Sunan Yasemin, Duru Fatma, Karteper Gülten, Erdoğan Yarikkaya Esra, Özsoy Betül, Öz Gökhan, Kahraman Şerif, Tatlı Gökhan, Öner Hidayet

出版信息

Turk Psikiyatri Derg. 2024 Sep 19;36:93-103. doi: 10.5080/u27182.

Abstract

OBJECTIVE

The objective of this study is to determine the prevalance of Hepatitis C Virus (HCV) in patients with Opioid Use Disorder and to investigate both the sociodemographic and psychological differences between patients with or without Hepatitis C Virus.

METHOD

Blood samples were taken from patients diagnosed with Opioid Use Disorder (OUD) who applied to Mersin Provincial Health Directorate Toros State Hospital Alcohol and Drug Addiction Treatment Center (AMATEM) between 01.09.2019-01.09.2020 and hepatitis virus markers, complete blood count and basic biochemistry were assessed. Sociodemographic Evaluation Form, Barratt Impulsivity Scale, Childhood Traumas Scale, Drug Use Disorders Identification Test (DUDIT), Temps-A Temperament Scale, Difficulty in Emotion Regulation Scale were applied to 107 patients with HCV and 101 patients without HCV who were selected by systematic sampling and the findings obtained were compared.

RESULTS

Of the 1190 patients diagnosed with Opioid Use Disorder, 340 (28.5%) were found to be HCV positive. 107 HCV-positive and 101 HCVnegative patients who were selected for comparison were similar in terms of sociodemographic characteristics. Among HCV positive patients, the rate of intravenous drug use and needle sharing were significantly higher (p<0.001, p<0.001). Overall duration of substance use and intravenous substance use were significantly higher in HCV positive patients (p=0.024 and p=0.017). Similarly, HCV positive group were significantly more likely (p<0.001) to have heard of HCV before and significantly more likely (p=0.009) to know that HCV causes cirrhosis and liver cancer. Regarding the scores of Barratt Impulsivity Scale, Childhood Traumas Scale, Substance Use Disorder Recognition Test, DUDIT, Temps -A Temperament Scales applied to HCV positive and HCV negative patients with Opioid Use Disorder, no difference was found. The scores of the 'Non-Acceptance' factor of the Difficulties in Emotion Regulation Scale were found to be significantly higher in HCV positive patients with Opioid Use Disorder (p=0.020).

CONCLUSION

Patients diagnosed with Opioid Use Disorder (OUD) have higher rates of HCV positivity compared to general public. Intravenous drug use significantly increases this risk. Half of HCV-positive patients were unaware that they have the virus and only a very small proportion received treatment. Therefore, examining each patient with OUD for HCV, treating positive patients in an effective referral system seems to be the an important step in the eradication of this disease in this population.

摘要

目的

本研究的目的是确定阿片类物质使用障碍患者中丙型肝炎病毒(HCV)的患病率,并调查感染或未感染丙型肝炎病毒患者之间的社会人口学和心理差异。

方法

对2019年9月1日至2020年9月1日期间申请到梅尔辛省卫生局托罗斯州立医院酒精和药物成瘾治疗中心(AMATEM)就诊的被诊断为阿片类物质使用障碍(OUD)的患者采集血样,评估肝炎病毒标志物、全血细胞计数和基本生化指标。对通过系统抽样选取的107例HCV阳性患者和101例HCV阴性患者应用社会人口学评估表、巴拉特冲动性量表、童年创伤量表、药物使用障碍识别测试(DUDIT)、Temps-A气质量表、情绪调节困难量表,并比较所得结果。

结果

在1190例被诊断为阿片类物质使用障碍的患者中,发现340例(28.5%)HCV呈阳性。被选作比较的107例HCV阳性患者和101例HCV阴性患者在社会人口学特征方面相似。在HCV阳性患者中,静脉注射吸毒和共用针头的比例显著更高(p<0.001,p<0.001)。HCV阳性患者的物质使用总时长和静脉注射物质使用时长显著更长(p=0.024和p=0.017)。同样,HCV阳性组更有可能(p<0.001)之前听说过HCV,并且更有可能(p=0.009)知道HCV会导致肝硬化和肝癌。对于应用于患有阿片类物质使用障碍的HCV阳性和HCV阴性患者的巴拉特冲动性量表、童年创伤量表、物质使用障碍识别测试、DUDIT、Temps-A气质量表的得分,未发现差异。发现情绪调节困难量表“不接受”因子的得分在患有阿片类物质使用障碍的HCV阳性患者中显著更高(p=0.020)。

结论

与普通人群相比,被诊断为阿片类物质使用障碍(OUD)的患者HCV阳性率更高。静脉注射吸毒显著增加了这种风险。一半的HCV阳性患者不知道自己感染了该病毒,只有极小部分患者接受了治疗。因此,对每例OUD患者进行HCV检测,并在有效的转诊系统中治疗阳性患者,似乎是在该人群中根除这种疾病的重要一步。

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