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西班牙注射吸毒者在成功接受直接作用抗病毒药物治疗后的丙型肝炎再感染率:LIVERate 研究。

Rate of hepatitis C reinfection after successful direct-acting antivirals treatment among people who inject drugs in Spain: the LIVERate study.

机构信息

Merck Sharp and Dohme, Madrid, Spain.

Álvaro Cunqueiro University Hospital, Vigo, Spain.

出版信息

BMC Public Health. 2024 Nov 14;24(1):3167. doi: 10.1186/s12889-024-20625-3.

Abstract

BACKGROUND

Hepatitis C virus (HCV) reinfection following successful treatment threatens the achievement of HCV elimination. The primary aim of this study is to assess reinfection rate three years after sustained virologic response (SVR) in people who inject drugs (PWID) that are on opioid agonist treatment (OAT) who underwent anti-HCV treatment with interferon-free regimens.

METHODS

Observational, non-interventional, prospective, descriptive study carried out in Spanish tertiary public hospitals between 2017 and 2022. Participants comprised 186 adult HCV infected individuals, 85.5% males with a mean age (Standard Deviation, SD) of 50.1 (5.9). All were enrolled in an OAT program at baseline and had attained SVR 12 weeks after therapy completion with an interferon-free treatment. Baseline data were abstracted from medical chart information collected through the routine clinical practice.

RESULTS

The overall rate of HCV reinfection three years after SVR12 among PWID was 1.2 new cases per 100 person-years of follow-up at a median of 15.9 months. In the subgroup analyses, those with injection drug practice and without a stable housing had higher reinfection rates.

CONCLUSION

Although PWID in OAT present a low rate of reinfection by HCV after successful treatment, a closer monitoring in the first year and strengthening inter-consultations with services responsible for monitoring addiction in these patients will be crucial to reduce risky behaviors avoiding HCV reinfection.

摘要

背景

成功治疗后的丙型肝炎病毒 (HCV) 再感染威胁着 HCV 消除的实现。本研究的主要目的是评估接受无干扰素方案治疗的接受阿片类药物替代治疗 (OAT) 的药物滥用者 (PWID) 在获得持续病毒学应答 (SVR) 后三年的再感染率。

方法

这是一项在 2017 年至 2022 年期间在西班牙三级公立医院进行的观察性、非干预性、前瞻性、描述性研究。参与者包括 186 名成年 HCV 感染个体,男性占 85.5%,平均年龄(标准差,SD)为 50.1(5.9)。所有参与者在基线时均参加 OAT 计划,并在完成无干扰素治疗后 12 周达到 SVR。基线数据是从通过常规临床实践收集的病历信息中提取的。

结果

在 SVR12 后三年,PWID 的 HCV 再感染总发生率为每 100 人年 1.2 例新病例,中位随访时间为 15.9 个月。在亚组分析中,有注射吸毒行为且无稳定住所的患者再感染率较高。

结论

尽管 OAT 中的 PWID 在成功治疗后 HCV 再感染率较低,但在第一年更密切的监测,并加强与负责监测这些患者成瘾情况的服务部门的协商,对于减少避免 HCV 再感染的危险行为至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e24/11566421/769bb91a2044/12889_2024_20625_Fig1_HTML.jpg

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