Interventions to enhance testing, linkage to care and treatment uptake for hepatitis C virus infection among people who inject drugs: A systematic review
Interventions to enhance testing, linkage to care and treatment uptake for hepatitis C virus infection among people who inject drugs: A systematic review
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DOI：
10.1016/j.drugpo.2017.07.002
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发表时间：
2017-09-01
影响因子：
4.4
通讯作者：
Grebely, Jason
中科院分区：
文献类型：
--
作者：
Bajis, Sahar;Dore, Gregory J.;Grebely, Jason
背景资料：丙型肝炎病毒（HCV）感染的负担在注射毒品（PWID）的人群中不断升级，但检测和治疗仍然不理想。本系统评价的目的是评估干预措施的有效性，以加强丙型肝炎病毒检测，与护理的联系，以及PWID中的治疗吸收。Medline系统文献检索（奥维德，1946年至今）、Embase、全球健康、科克伦对照试验中心注册、PsycINFO、临床试验注册，Web of Science涵盖了2016年7月20日之前发表的干预性研究。研究评估干预措施，以加强丙型肝炎病毒检测，联系到护理或治疗PWID。纳入研究的数据由一名审查员提取，并由第二名审查员进行检查，讨论分歧，直至达成共识。相对风险比和相应的置信区间生成的研究包括在analysis.Results：调整后的重复，10,116条记录被确定。共纳入14项研究进行分析，其中57%为随机对照试验。加强丙型肝炎病毒检测的干预措施包括现场检测，并提供检测前咨询和教育;以及干血斑检测。干预措施，以加强联系，以照顾包括促进转诊丙型肝炎病毒的评估和安排专家预约的客户。提高HCV治疗吸收的干预措施包括由多学科团队提供的综合HCV护理，药物使用和精神病服务，包括病例管理服务，有或没有非侵入性肝病评估。所有的研究都进行了干扰素治疗的时代，并没有在低收入和中等收入countries.Conclusions：在直接作用的抗病毒治疗时代，精心设计的研究评估干预措施，以提高简化的护理级联是至关重要的，在促进治疗规模扩大。(C)2017爱思唯尔B. V.保留所有权利。
Background: The burden of hepatitis C virus (HCV) infection is escalating among people who inject drugs (PWID), yet testing and treatment remains suboptimal. The aim of this systematic review was to evaluate the effectiveness of interventions to enhance HCV testing, linkage to care, and treatment uptake among PWID.Methods: A systematic literature search of Medline (Ovid 1946 - present), Embase, Global Health, Cochrane Central Register of Controlled Trials, PsycINFO, Clinical Trials Registry, and Web of Science was conducted covering interventional studies published before 20 July 2016. Studies evaluating interventions to enhance HCV testing, linkage to care or treatment among PWID were included. Data from included studies was extracted by one reviewer and checked by a second reviewer with disagreements discussed until consensus was reached. Relative risk ratios and corresponding confidence intervals were generated for studies included in analysis.Results: After adjusting for duplicates, 10,116 records were identified. A total of 14 studies were included for analysis, of which 57% were randomised controlled trials. Interventions to enhance HCV testing included on-site testing with pre-test counselling and education; and dried blood spot testing. Interventions to enhance linkage to care included facilitated referral for HCV assessment and scheduling of specialist appointments for clients. Interventions to enhance HCV treatment uptake included integrated HCV care, drug use and psychiatric services delivered by a multidisciplinary team with case management services, with or without non-invasive liver disease assessment. All studies were conducted in the interferon treatment era and there were no studies conducted in low- and middle-income countries.Conclusions: In the direct acting antiviral treatment era, well-designed studies evaluating interventions to enhance a simplified care cascade are crucial in facilitating treatment scale-up. (C) 2017 Elsevier B.V. All rights reserved.