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Harm reduction, hepatitis C and opioid pharmacotherapy: an opportunity for integrated hepatitis C virus-specific harm reduction.

机译：减少伤害，丙型肝炎和阿片类药物疗法：减少丙型肝炎病毒特异性综合危害的机会。

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摘要

While harm reduction advocates, policy makers and practitioners have a right to be proud of the impact of interventions such as needle and syringe programmes on HIV risk, we can be less sanguine about the ongoing high levels of HCV transmission among injecting drug users (IDUs) and the expanding burden of hepatitis C virus (HCV)-related liver disease. In this Harm Reduction Digest Drs Byrne and Hallinan from the Redfern Clinic and Dr Dore from the National Centre in HIV Epidemiology and Clinical Research offer a model of integrated HCV prevention and treatment services within the setting of opioid pharmacotherapy. In their experience, this common-sense approach provides an opportunity to reduce the burden of HCV and improve overall patient management. They believe that the key elements of a HCV-specific harm reduction model include: regular HCV testing; clinical assessment and determination of need for HCV treatment referral; use of broader HCV treatment inclusion criteria; and flexibility in opioid pharmacotherapy dosing. In an environment when our macro harm reduction interventions seem to have, at best, modest impact on HCV transmission, good clinical practice may be our most effective strategy against the HCV epidemic. This paper provides some practical suggestions as to how this can be done.
机译：虽然减少危害的倡导者，政策制定者和从业者有权为诸如针头和注射器计划等干预措施对艾滋病毒风险的影响而感到自豪，但对于注射毒品使用者（IDU）中持续不断的高水平的HCV传播，我们可能不太乐观以及与丙型肝炎病毒（HCV）相关的肝病负担的增加。在这份减少危害的文摘中，来自Redfern诊所的Byrne博士和Hallinan博士以及来自HIV流行病学和临床研究国家中心的Dore博士提供了在阿片类药物治疗范围内整合的HCV预防和治疗服务的模型。根据他们的经验，这种常识性方法为减少HCV负担和改善整体患者管理提供了机会。他们认为，HCV特定危害减少模型的关键要素包括：常规HCV测试;临床评估和确定是否需要转诊HCV;使用更广泛的HCV治疗纳入标准;和阿片类药物治疗剂量的灵活性。在我们的宏观减害干预措施似乎最多不会对HCV传播产生适度影响的环境中，良好的临床实践可能是我们应对HCV流行病最有效的策略。本文提供了一些有关如何完成此操作的实用建议。

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