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首页> 外文期刊>The International journal of drug policy >Recruitment and follow-up of injecting drug users in the setting of early hepatitis C treatment: insights from the ATAHC study.
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Recruitment and follow-up of injecting drug users in the setting of early hepatitis C treatment: insights from the ATAHC study.

机译：丙型肝炎早期治疗中注射吸毒者的招募和跟进：ATAHC研究的见解。

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Despite current injecting drug users (IDUs) being the major risk group for new hepatitis C virus (HCV) infections in most countries, they constitute a small minority of study populations in almost all studies of acute HCV infection treatment. The Australian Trial in Acute Hepatitis C (ATAHC) is examining natural history and treatment efficacy among predominantly IDU-acquired acute HCV. Recruitment is through an Australian network of primary and tertiary care sites. Eligible participants are offered treatment with pegylated-interferon alpha-2a (PEG-IFN) for 24 weeks, with both treated and untreated participants followed for up to three years. Quantitative and qualitative data on injecting behaviour is collected on study participants. Participants are regularly reviewed by a multidisciplinary team that includes the treating clinician, HCV clinic nurse, outreach worker and when necessary are referred to a drug and alcohol worker, social worker, psychiatrist or other appropriate services. A contact log records all interactions between participants and the study team. In September 2006, 121 subjects had been screened, 107 were enrolled and 75 had chosen to commence a 24-week course of PEG-IFN (HIV/HCV coinfected participants are treated with PEG-IFN/ribavirin combination therapy). Eighty per cent of ATAHC participants reported IDU within the previous six months. Recruitment is planned to continue through mid-2007. Through a series of case reports, this paper describes factors that are potential barriers to recruitment, follow-up, and treatment of IDUs in the context of acute HCV infection. PEG-IFN adherence and toxicity, current substance use or mental health issues are not presenting as the only barriers to HCV treatment. Financial and transport difficulties, isolation and social support, and legal issues have been prominent and had the potential to impact on clinic attendance and treatment success. Our work suggests that by using a multidisciplinary approach, potential barriers to recruitment and follow-upof current IDUs to HCV treatment can be effectively addressed, and this highly marginalised population can be successfully engaged and treated.
机译：尽管在大多数国家，当前的注射吸毒者（IDU）是新的丙型肝炎病毒（HCV）感染的主要危险人群，但在几乎所有急性HCV感染治疗的研究中，他们都是少数的研究人群。澳大利亚急性丙型肝炎试验（ATAHC）正在检查以IDU为主的急性HCV的自然病史和治疗效果。招聘通过澳大利亚的初级和三级护理站点网络进行。为符合条件的参与者提供聚乙二醇化干扰素α-2a（PEG-IFN）治疗24周，接受治疗和未经治疗的参与者均接受长达三年的随访。研究对象收集了有关注射行为的定量和定性数据。参加者由多学科团队定期审查，该团队包括主治临床医生，HCV诊所护士，外展人员，并在必要时转介给毒品和酒精工作者，社会工作者，精神病医生或其他适当服务。联系人日志记录了参与者与研究团队之间的所有互动。在2006年9月，已经筛选了121位受试者，招募了107位受试者，其中75位选择开始PEG-IFN的24周疗程（HIV / HCV合并感染的受试者接受PEG-IFN /利巴韦林联合治疗）。在过去六个月中，有80％的ATAHC参与者报告了IDU。招聘计划将持续到2007年中期。通过一系列病例报告，本文描述了在急性HCV感染的情况下可能对IDU的招募，随访和治疗造成障碍的因素。 PEG-IFN的依从性和毒性，当前使用的药物或精神健康问题并未成为HCV治疗的唯一障碍。财务和运输困难，隔离和社会支持以及法律问题一直很突出，并有可能影响诊所出诊率和治疗成功率。我们的工作表明，通过采用多学科方法，可以有效地解决现有的注射毒品使用者接受HCV治疗的潜在招募障碍和后续行动，并且可以成功地参与和治疗这一高度边缘化的人群。

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