We Must Do Better: Addressing HCV Treatment Barriers in Persons Who Inject Drugs in the United States
We Must Do Better: Addressing HCV Treatment Barriers in Persons Who Inject Drugs in the United States
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DOI：
10.1093/infdis/jiaa574
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发表时间：
2020-12-15
影响因子：
6.4
通讯作者：
Kostman, Jay
中科院分区：
文献类型：
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作者：
Trooskin, Stacey B.;Dore, Gregory;Kostman, Jay
美国的阿片类药物流行，加上缺乏足够的减害服务，导致丙型肝炎病毒 (HCV) 感染急剧上升。尽管有大量证据表明 HCV 治疗对注射吸毒者 (PWID) 有效，并且临床指南也建议优先考虑注射吸毒者的治疗，但广泛采用 HCV 治疗仍存在多重障碍。这些障碍存在于系统层面以及医疗提供者和患者层面。在美国，消除治疗障碍的干预措施包括减少伤害服务、简化丙肝病毒检测算法、改善与丙肝病毒护理服务的联系以及应用新的治疗模式，包括在物质使用障碍治疗项目中提供并置服务。通过追随其他国家解决丙肝治疗障碍的做法，美国有机会在解决阿片类药物流行的后果（包括慢性丙肝感染）方面做得更好。
The opioid epidemic in the United States, along with a lack of adequate harm reduction services, has contributed to a sharp rise in hepatitis C virus (HCV) infections. Despite considerable evidence of the effectiveness of HCV treatment in people who inject drugs (PWID), and recommendations from clinical guidelines to prioritize treatment in PWID, there are multiple barriers to broad uptake of HCV treatment. These barriers exist at the systems level, as well as at the level of medical providers and patients. Interventions to remove treatment barriers in the United States include harm reduction services, simplifying HCV testing algorithms, improved linkage to HCV care services, and application of new treatment models including colocating services at substance use disorder treatment programs. By following the lead of other countries who have addressed the barriers to HCV treatment, the United States has opportunities to do better in addressing the consequences of the opioid epidemic, including chronic HCV infection.