Cascade of Hepatitis C Virus Care Among Patients With Substance Use Disorders.
Cascade of Hepatitis C Virus Care Among Patients With Substance Use Disorders.
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DOI：
10.1016/j.amepre.2021.04.013
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发表时间：
2021-10
影响因子：
5.5
通讯作者：
Park H
中科院分区：
文献类型：
--
作者：
Jiang X;Parker RL;Vouri SM;Lo-Ciganic W;Diaby V;Henry L;Park H
丙型肝炎病毒（HCV）检测建议用于感染高危人群，包括物质使用障碍（SUD）患者。在现实世界的临床实践中，人们对SUD患者的HCV级联治疗（包括检测、诊断和治疗）知之甚少。本研究旨在描述HCV级联治疗的特征，并确定佛罗里达州医疗补助受益人中患有SUD的HCV检测和诊断相关因素。2020年，对佛罗里达州医疗补助数据（2013-2018）进行了回顾性队列分析，对象为18-64岁新诊断为SUD的患者（2012年确定入组前1年）。一个广义估计方程确定了与HCV检测相关的因素；多变量logistic模型确定了与HCV诊断相关的因素。在156770名SUD患者中，18%的患者至少接受了一次HCV检测。在接受检测的患者中，有8%被诊断为丙型肝炎病毒。在诊断为HCV的2177例患者中，11%的人开始了HCV治疗，96%的人完成了HCV治疗。与不太可能接受HCV检测相关的因素包括男性（AOR=0.73, 95% CI=0.71, 0.75）和白人（AOR=0.85, 95% CI=0.83, 0.87），而男性（AOR=1.49, 95% CI=1.35, 1.66）和白人（AOR=2.71, 95% CI=2.38, 3.08）更容易被诊断为HCV。接受HCV检测的几率每年显著增加（AOR=1.06, 95% CI=1.05, 1.07）。未来的研究有必要调查佛罗里达州医疗补助受益人中患有SUD的HCV检测和治疗的障碍，特别是白人男性个体。
Hepatitis C virus (HCV) testing is recommended for people at high risk for infection, including those with substance use disorders (SUD). Little is known about the cascade of HCV care (including testing, diagnosis, and treatments) among patients with SUD in real-world clinical practice. This study aims to characterize the HCV cascade of care and identify the factors associated with HCV testing and diagnosis among Florida Medicaid beneficiaries with SUD. A retrospective cohort analysis of Florida Medicaid data (2013–2018) was conducted in 2020 for patients aged 18–64 years with a newly diagnosed SUD (year 2012 was used to ascertain 1-year prior enrollment). A generalized estimating equation identified factors associated with HCV testing; multivariable logistic model identified factors associated with HCV diagnosis. Of the 156,770 patients with SUD, 18% were tested for HCV at least once. Among the tested patients, 8% had HCV diagnoses. Among the 2,177 patients having an HCV diagnosis, 11% initiated HCV treatments and 96% of them completed the HCV treatments. Factors associated with being less likely to receive HCV testing included being male (AOR=0.73, 95% CI=0.71, 0.75) and White (AOR=0.85, 95% CI=0.83, 0.87), whereas individuals who were male (AOR=1.49, 95% CI=1.35, 1.66) and White (AOR=2.71, 95% CI=2.38, 3.08) were more likely to be diagnosed with HCV. The odds of receiving HCV testing significantly increased annually (AOR=1.06, 95% CI=1.05, 1.07). Future studies are warranted to investigate barriers for access to HCV testing and treatment among Florida Medicaid beneficiaries with SUD, especially for White male individuals.
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影响因子：
2.4
作者：
Fuster D;Sanvisens A;Bolao F;Rivas I;Tor J;Muga R
通讯作者：
Muga R
影响因子：
4.2
作者：
Fill, M. A.;Sizemore, L. A.;Wester, C.
通讯作者：
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影响因子：
11.8
作者：
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Grebely, Jason
DOI：
10.15585/mmwr.mm6638a3
发表时间：
2017-09-29
期刊：
MMWR. Morbidity and mortality weekly report
影响因子：
--
作者：
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通讯作者：
Zucker HA
影响因子：
13.5
作者：
Backus, Lisa I.;Belperio, Pamela S.;Mole, Larry A.
通讯作者：
Mole, Larry A.