Hepatitis C Virus Testing and Treatment Among Persons Receiving Buprenorphine in an Office-Based Program for Opioid Use Disorders
Hepatitis C Virus Testing and Treatment Among Persons Receiving Buprenorphine in an Office-Based Program for Opioid Use Disorders
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DOI：
10.1016/j.jsat.2016.01.009
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发表时间：
2016-07-01
影响因子：
3.9
通讯作者：
Tsui, Judith I.
中科院分区：
文献类型：
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作者：
Carey, Katelyn J.;Huang, Wei;Tsui, Judith I.
目的：在美国，丙型肝炎病毒（HCV）感染主要通过注射毒品传播。迫切需要改善注射毒品的阿片类药物使用障碍患者获得HCV护理的机会。我们的研究的目的是确定HCV的患病率，患者的特点，并接受适当的照顾，在一个样本的患者治疗与丁丙诺啡阿片类药物使用障碍在初级保健setting.Methods：本研究采用回顾性临床数据的电子病历。研究人群包括2003年10月至2013年8月期间在波士顿医疗中心成人初级医学诊所内的办公室阿片类药物治疗（OBOT）诊所接受丁丙诺啡治疗的患者，这些患者在进入诊所一年内接受了结论性HCV抗体（Ab）检测。我们比较了HCV血清学状态使用皮尔逊卡方和提供的数字/百分比接受适当的care.Results的特征：样本包括700例患者。略少于一半的患者（n = 334，47.7%）HCV抗体阳性，并显着更有可能是老年人，西班牙裔或非洲裔美国人，有创伤后应激障碍（PTSD）或双相情感障碍的诊断，有海洛因或可卡因的使用，并感染艾滋病毒。在334例HCV抗体阳性患者中，（67.7%）有可检测的HCV核糖核酸（RNA），表明慢性HCV感染;（2.21%）的慢性HCV感染者曾开始治疗。近一半的患者（47.7%）接收办事处─使用丁丙诺啡治疗阿片类药物使用障碍的患者的丙型肝炎病毒抗体筛查试验呈阳性，尽管几乎不存在HCV治疗的启动（2.21%）。(C)2016 Elsevier Inc. All rights reserved.
Aims: In the United States, hepatitis C virus (HCV) infection is primarily spread through injection drug use. There is an urgent need to improve access to care for HCV among persons with opioid use disorders who inject drugs. The purpose of our study was to determine the prevalence of HCV, patient characteristics, and receipt of appropriate care in a sample of patients treated with buprenorphine for their opioid use disorders in a primary care setting.Methods: This study used retrospective clinical data from the electronic medical record. The study population included patients receiving buprenorphine in the Office Based Opioid Treatment (OBOT) clinic within the adult primary medicine clinic at Boston Medical Center between October 2003 and August 2013 who received a conclusive HCV antibody (Ab) test within a year of clinic entry. We compared characteristics by HCV serostatus using Pearson's chi-square and provided numbers/percentages receiving appropriate care.Results: The sample comprised 700 patients. Slightly less than half of all patients (n = 334, 47.7%) were HCV Ab positive, and were significantly more likely to be older, Hispanic or African American, have diagnoses of post traumatic stress disorder (PTSD) or bipolar disorder, have prior heroin or cocaine use, and be HIV-infected. Among the 334 HCV Ab positive patients, 226 (67.7%) had detectable HCV ribonucleic acid (RNA) indicating chronic HCV infection; only 5 patients (2.21%) with chronic HCV infection ever initiated treatment.Conclusions: Nearly half of patients (47.7%) receiving office-based treatment with buprenorphine for their opioid use disorder had a positive hepatitis C virus antibody screening test although initiation of HCV treatment was nearly non-existent (2.21%). (C) 2016 Elsevier Inc. All rights reserved.