Clinical trial: a primary-care-based model for the delivery of anti-viral treatment to injecting drug users infected with hepatitis C
Clinical trial: a primary-care-based model for the delivery of anti-viral treatment to injecting drug users infected with hepatitis C
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DOI：
10.1111/j.1365-2036.2008.03872.x
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发表时间：
2009-01-01
影响因子：
7.6
通讯作者：
Thomson, B. J.
中科院分区：
文献类型：
--
作者：
Jack, K.;Willott, S.;Thomson, B. J.
背景注射吸毒是丙型肝炎病毒（HCV）感染的主要危险因素。二级保健为基础的策略，为管理丙型肝炎病毒没有有效地针对这一脆弱population.Aims评估的可行性，安全性和有效性的初级保健为基础的模式提供丙型肝炎病毒服务，包括抗病毒治疗注射吸毒者。一个以二级保健为基础的肝炎服务机构以及药物工作者和全科医生。三百五十三名客户参加阿片类药物替代诊所在初级保健进行了评估。结果是：结果共检出HCV抗体阳性者174例，阳性率为100%。其中，124人慢性感染HCV，其中只有6人以前被确定。在118名新的慢性感染者中，86人进入了护理途径，43人被评估为适合抗病毒治疗，30人迄今已接受治疗。抗病毒治疗的结果与那些在二级保健settings.Conclusion初级保健为基础的模型提供了一个新的范式注射吸毒者的HCV治疗。
Background Injecting drug use is the main risk factor for hepatitis C virus (HCV) infection. Secondary-care-based strategies for the management of HCV do not effectively target this vulnerable population.Aims To evaluate the feasibility, safety and efficacy of a primary-care-based model for the delivery of HCV services including anti-viral therapy to injecting drug users.Methods A partnership between a clinical nurse specialist employed by, and working under the supervision of, a secondary-care-based hepatitis service and drug workers and general practitioners. Three hundred and fifty-three clients attending opiate substitution clinics in primary care were evaluated. Outcomes were: number of new diagnoses of HCV infection, number of clients assessed as suitable for anti-viral treatment, and number of patients treated.Results 174 HCV antibody positive clients were identified. Of these, 124 were chronically infected with HCV of whom only six had been previously identified. Of 118 new chronically-infected individuals, 86 entered the care pathway, 43 were assessed as suitable for anti-viral treatment and 30 have so far been treated. Outcomes of anti-viral treatment are comparable with those obtained in secondary care settings.Conclusion A primary-care-based model offers a new paradigm for the treatment of HCV in injecting drug users.