Prevention and treatment of hepatitis C in injection drug users
Prevention and treatment of hepatitis C in injection drug users
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DOI：
10.1053/jhep.2002.36809
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发表时间：
2002-11-01
期刊：
影响因子：
13.5
通讯作者：
Edlin, BR
中科院分区：
文献类型：
--
作者：
Edlin, BR
注射吸毒者是美国最大的丙型肝炎病毒(HCV)感染者群体，大多数新感染病例发生在吸毒者身上。因此，在美国人口中控制丙型肝炎将需要为注射吸毒者制定、测试和实施有效的预防和治疗策略。幸运的是，在预防和管理注射吸毒者的慢性病毒疾病方面，已经有大量的研究和临床经验。需要采取干预措施阻止丙型肝炎病毒在吸毒者中传播，这一点至关重要。需要扩大药物使用治疗方案的能力，以容纳所有想要和需要治疗的人。医生和药剂师应该接受关于如何提供无菌注射器和安全注射技术的教育，这两者都是挽救生命的干预措施。治疗吸毒者的丙型肝炎需要一种跨学科的方法，将治疗肝炎和护理吸毒者的专业知识结合起来。治疗决定应该由患者和他们的医生在平衡评估风险和收益以及患者的个人价值的基础上做出。医生应该仔细评估、监测和支持所有患者的依从性和心理健康，无论是否知道或怀疑使用药物。需要进行研究，以更好地了解如何最好地预防和治疗药物使用者的丙型肝炎。与此同时，如果利用现有的知识和资源，就可以取得实质性的进展。
Injection drug users constitute the largest group of persons infected with the hepatitis C virus (HCV) in the United States, and most new infections occur in drug users. Controlling hepatitis C in the U.S. population, therefore, will require developing, testing, and implementing effective prevention and treatment strategies for persons who inject drugs. Fortunately, a substantial body of research and clinical experience exists on the prevention and management of chronic viral diseases among injection drug users. The need to implement interventions to stop the spread of HCV among drug users is critical. The capacity of substance-use treatment programs need to be expanded to accommodate all who want and need treatment. Physicians and pharmacists should be educated in how to provide access to sterile syringes and to teach safe injection techniques, both of which are lifesaving interventions. The treatment of hepatitis C in drug users requires an interdisciplinary approach that brings together expertise in treating hepatitis and caring for drug users. Treatment decisions should be made individually by patients with their physicians, based on a balanced assessment of risks and benefits and the patient's personal values. Physicians should carefully assess, monitor, and support adherence and mental health in all patients, regardless of whether drug use is known or suspected. Research is needed to better understand how best to prevent and treat hepatitis C in substance users. In the meantime, substantial progress can be made if existing knowledge and resources are brought to bear.