Clinicians' Views of Hepatitis C Virus Treatment Candidacy With Direct-Acting Antiviral Regimens for People Who Inject Drugs.
Clinicians' Views of Hepatitis C Virus Treatment Candidacy With Direct-Acting Antiviral Regimens for People Who Inject Drugs.
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DOI：
10.3109/10826084.2016.1161054
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发表时间：
2016-07-28
影响因子：
2
通讯作者：
Page KA
中科院分区：
文献类型：
--
作者：
Asher AK;Portillo CJ;Cooper BA;Dawson-Rose C;Vlahov D;Page KA
直接作用抗病毒药物（DAA）对大多数慢性丙型肝炎病毒（HCV）感染者具有疗效。然而，高成本和对依从性和再感染的担忧可能会继续阻碍治疗，特别是对于注射毒品的人（PWID）。了解随着治疗进展，治疗候选资格评估的变化。参加2014年Liver Meeting®的临床医生报告在过去三年中处方HCV治疗，被邀请完成关于HCV治疗决策的调查。参与者评估了他们在PWID中治疗HCV的可能性与戒断注射药物的时间以及影响他们使用干扰素和DAA治疗的决定的因素。108名临床医生完成了调查; 10%的人愿意使用含干扰素的方案治疗活动性PWID（30天内最后一次注射），15%的人愿意使用全口服方案。对于每增加一次注射戒断时间间隔，临床医生报告愿意接受DAA治疗（比值比（OR）2.57，95% CI 2.18，3.03）和基于干扰素的治疗（OR 2.22（95% CI 1.90，2.61））的几率增加，在确定候选人资格时，再感染和药物费用被认为是最重要的问题。治愈现在是HCV治疗的规范，并且越来越需要解决治疗PWID的障碍，PWID是感染负担最高的人群。了解治疗候选资格评估对提高吸收率至关重要。这项研究提供了深入了解临床医生如何看待治疗候选人在这个时代的DAA，并可以帮助确定支持性治疗环境和并行程序。
Direct-acting antivirals (DAAs) are curative in most persons with chronic hepatitis C virus (HCV) infection. However, high cost and concerns about adherence and reinfection may present continued barriers to treatment, particularly for people who inject drugs (PWID). To understand changes in assessments of treatment candidacy, given advances in treatment. Clinicians attending the Liver Meeting® in 2014 who reported prescribing HCV treatment in the past three years were invited to complete a survey regarding HCV treatment decisions. Participants assessed their likelihood to treat HCV in PWID in association with time of abstinence from injection drug use and what impacts their decision to provide treatment using interferon and DAAs. 108 clinicians completed the survey; 10% were willing to treat an active PWID (last injection within 30 days) using interferon-containing regimens, and 15% with all-oral regimens. For each increasing time interval of injection abstinence, there was an increase in the odds of a clinician reporting willingness to treat with DAAs (Odds Ratio (OR) 2.57, 95% CI 2.18, 3.03) and with interferon-based treatment (OR 2.22 (95% CI 1.90, 2.61), Reinfection and medication cost were cited as most important concerns when determining candidacy. A cure is now the norm in HCV treatment, and there is an increasing need to address the barriers to treating PWID, the population with the highest burden of infection. Understanding treatment candidacy assessments is essential to improving uptake. This study provides insight into how clinicians view treatment candidacy in this era of DAAs and can help identify supportive treatment environments and concurrent programs.
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DOI：
10.1111/j.1440-1746.2010.06238.x
发表时间：
2010-07-01
影响因子：
4.1
作者：
Grebely, Jason;Knight, Elizabeth;Conway, Brian
通讯作者：
Conway, Brian
DOI：
10.1016/j.jana.2011.01.006
发表时间：
2012-01
影响因子：
2
作者：
Asher, Alice;Lum, Paula J.;Page, Kimberly
通讯作者：
Page, Kimberly
影响因子：
2.7
作者：
Myles, Angelique;Mugford, Gerry J.;Wang, Peizhong Peter
通讯作者：
Wang, Peizhong Peter
影响因子：
11.8
作者：
Strathdee, SA;Latka, M;Hagan, H
通讯作者：
Hagan, H
DOI：
10.1111/liv.12063
发表时间：
2013-02
期刊：
Liver international : official journal of the International Association for the Study of the Liver
影响因子：
--
作者：
Hagan LM;Schinazi RF
通讯作者：
Schinazi RF