Models of Care for the Management of Hepatitis C Virus Among People Who Inject Drugs: One Size Does Not Fit All
Models of Care for the Management of Hepatitis C Virus Among People Who Inject Drugs: One Size Does Not Fit All
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DOI：
10.1093/cid/cit271
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发表时间：
2013-08-15
影响因子：
11.8
通讯作者：
Litwin, Alain H.
中科院分区：
文献类型：
--
作者：
Bruggmann, Philip;Litwin, Alain H.
注射吸毒者（PWID）丙型肝炎病毒（HCV）治疗的主要障碍之一是缺乏适合这一弱势群体需求的治疗环境。尽管如此，通过各种多学科模式，如社区诊所、药物滥用治疗诊所和专科医院诊所，已成功地为PWID提供了HCV治疗。模型可以集成在初级保健所有在一个屋檐下，无论是成瘾护理单位或一般戒毒为基础的模型，或可以发生在二级或三级保健设置。其他创新模式包括直接观察治疗和基于同伴的模式。对PWID的个人生活情况的高度接受，而不是严格的排除标准，将决定任何HCV管理模式的成功水平。只要治疗不能扩大到受影响最大的风险群体，高效和耐受性良好的无干扰素HCV治疗方案的影响将仍然可以忽略不计。
One of the major obstacles to hepatitis C virus (HCV) care in people who inject drugs (PWID) is the lack of treatment settings that are suitably adapted for the needs of this vulnerable population. Nevertheless, HCV treatment has been delivered successfully to PWID through various multidisciplinary models such as community-based clinics, substance abuse treatment clinics, and specialized hospital-based clinics. Models may be integrated in primary care-all under one roof in either addiction care units or general practitioner-based models-or can occur in secondary or tertiary care settings. Additional innovative models include directly observed therapy and peer-based models. A high level of acceptance of the individual life circumstances of PWID rather than rigid exclusion criteria will determine the level of success of any model of HCV management. The impact of highly potent and well-tolerated interferon-free HCV treatment regimens will remain negligible as long as access to therapy cannot be expanded to the most affected risk groups.