Loss to follow-up: A significant barrier in the treatment cascade with direct-acting therapies
Loss to follow-up: A significant barrier in the treatment cascade with direct-acting therapies
复制标题
失访：直接作用治疗级联治疗中的一个重大障碍
DOI：
10.1111/jvh.13228
复制
发表时间：
2019-12-02
影响因子：
2.5
通讯作者：
Janjua, Naveed Z.
中科院分区：
文献类型：
--
作者：
Darvishian, Maryam;Wong, Stanley;Janjua, Naveed Z.
直接作用抗病毒（DAA）治疗的有效性可能受到患者特征（如合并症）的影响，这可能导致提前停止治疗和/或不定期的医学随访。在此，我们评估了索非布韦/雷迪帕韦+/-利巴韦林的失访和治疗效果。（SOF/LDV +/- RBV），奥比他韦/帕利匹韦/利托那韦+达沙布韦+/-利巴韦林（OBV/PTV/r + DSV +/- RBV）用于丙型肝炎病毒（HCV）基因型1（GT 1）和索非布韦+利巴韦林加拿大不列颠哥伦比亚省基因型3（GT 3）的（SOF + RBV）：不列颠哥伦比亚省肝炎检测人员队列包括自1992年以来检测HCV的个人数据，结合医疗访问，住院和处方药数据。纳入了在2017年12月31日之前开始DAA方案治疗GT 1和GT3的HCV阳性个体，无论治疗是否完成。与持续病毒学应答（SVR）和失访相关的因素采用多变量logistic回归模型进行评估。共有4477人发起了DAA。最常见的处方DAA为SOF/LDV +/- RBV，SVR为95%。在OBV/PTV/r + DSV治疗的患者中观察到最高SVR为99.5%。总体而言，453名（10.1%）患者失访。在接受OBV治疗的GT 1患者（17.8%）和GT3患者（15.7%）中观察到较高的失访率。失访率在年龄较大的个体中显著较高，
Effectiveness of direct-acting antiviral (DAA) therapies could be influenced by patient characteristics such as comorbid conditions, which could lead to premature treatment discontinuation and/or irregular medical follow-ups. Here, we evaluate loss to follow-up and treatment effectiveness of sofosbuvir/ledipasvir +/- ribavirin (SOF/LDV +/- RBV), ombitasvir/paritaprevir/ritonavir + dasabuvir +/- ribavirin (OBV/PTV/r + DSV +/- RBV) for hepatitis C virus (HCV) genotype 1 (GT1) and sofosbuvir + ribavirin (SOF + RBV) for genotype 3 (GT3) in British Columbia Canada: The British Columbia Hepatitis Testers Cohort includes data on individuals tested for HCV since 1992, integrated with medical visit, hospitalization and prescription drug data. HCV-positive individuals who initiated DAA regimens, irrespective of treatment completion, for GT1 and GT3 until 31 December, 2017 were included. Factors associated with sustained virological response (SVR) and loss to follow-up were assessed by using multivariable logistic regression models. In total 4477 individuals initiated DAAs. The most common prescribed DAA was SOF/LDV +/- RBV with SVR of 95%. The highest SVR of 99.5% was observed among OBV/PTV/r + DSV-treated patients. Overall, 453 (10.1%) individuals were lost to follow-up. Higher loss to follow-up was observed among GT1 patients treated with OBV (17.8%) and GT3 patients (15.7%). The loss to follow-up rate was significantly higher among individuals aged