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首页> 外文期刊>The International journal of drug policy >High HCV cure rates among people who inject drugs and have suboptimal adherence: A patient-centered approach to HCV models of care
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High HCV cure rates among people who inject drugs and have suboptimal adherence: A patient-centered approach to HCV models of care

机译：注入药物的人们的高HCV治愈率，并具有次优遵守：以患者为中心的HCV护理模型的方法

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Background: Though people who inject drugs (PWID) make up the majority of the hepatitis C virus (HCV) epi-demic, concerns about adherence often exclude PWID from receiving direct-acting antiviral (DAA) medication. The most effective models of HCV care to promote sustained virologic response (SVR) and high adherence need to be evaluated. Methods: We conducted a prospective cohort study in three opioid treatment programs (OTPs) in the Bronx, NY. Participants, in collaboration with providers, chose one of three models of onsite care: directly observed therapy (mDOT), group treatment (GT), or self-administered individual treatment (SIT). SVR12, daily adherence, and participant characteristics were compared between groups. Results: Of 61 participants, the majority were male (62%) and Latino (67%), with a mean age of 53 (SD 9). Participants received DAAs via one of three models of care: mDOT (21%), GT (25%), or SIT (54%). The majority (59%) used illicit drugs during treatment. Overall, SVR12 was 98% with no differences between models of care: mDOT (100%), GT (100%), and SIT (97%) ( p = 1.0). Overall, daily adherence was 73% (SD 16); 86% among those who chose mDOT compared to 71% among those who chose GT ( p < 0.01) and 73% among those who chose SIT ( p < 0.01). Conclusion: Despite ongoing illicit drug use and suboptimal adherence, SVR12 was high among PWID treated onsite at an OTP using any one of three models of care. Shared decision making in real world settings may be key to choosing the appropriate model of care for PWID.
机译：背景：尽管注射药物（PWID）的人在丙型肝炎病毒（HCV）计划免疫中占大多数，但对依从性的担忧往往使PWID无法接受直接作用抗病毒药物（DAA）治疗。需要评估促进持续病毒学应答（SVR）和高依从性的最有效HCV护理模式。方法：我们在纽约布朗克斯对三种阿片类药物治疗方案（OTP）进行了前瞻性队列研究。参与者与提供者合作，从三种现场护理模式中选择一种：直接观察治疗（mDOT）、团体治疗（GT）或自我管理个体治疗（SIT）。比较各组之间的SVR12、每日依从性和参与者特征。结果：61名参与者中，大多数为男性（62%）和拉丁裔（67%），平均年龄53岁（SD 9）。参与者通过三种护理模式之一接受DAA：mDOT（21%）、GT（25%）或SIT（54%）。大多数人（59%）在治疗期间使用非法药物。总体而言，SVR12为98%，两种护理模式之间没有差异：mDOT（100%）、GT（100%）和SIT（97%）（p=1.0）。总体而言，每日依从性为73%（SD 16）；在选择mDOT的人群中，86%的人选择了GT（p<0.01），而在选择SIT的人群中，这一比例分别为71%和73%（p<0.01）。结论：尽管存在非法药物使用和次优依从性，但在OTP现场治疗的PWID患者中，使用三种护理模式中的任何一种，SVR12的比例都很高。现实世界中的共同决策可能是选择适当的PWID护理模式的关键。

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