Pre-Chemotherapeutic Care of HCV Infected Drug Users

描述（由申请人提供）： 吸毒者中慢性丙型肝炎（HCV）感染的护理是一个重要的公共卫生问题，其中许多人同时感染艾滋病毒。对于慢性HCV感染的吸毒者，酒精和积极药物滥用，高抑郁率，对甲型肝炎和B型肝炎感染的易感性，以及HIV合并感染只是影响HCV化疗参与和结果的几个变量。注意这些“化疗前”因素为吸毒者将来可能更有效的HCV化疗做好准备。然而，很少有人知道这些“化疗前”的因素是否成功地解决了慢性HCV管理的背景下。 候选人提出以下具体目标： 1)确定慢性丙型肝炎病毒感染吸毒者化疗前护理的参与率。 2)确定与认识和接受特异性化疗以外的干预措施以减少慢性HCV感染进展和为未来化疗做准备相关的因素。 该候选人提出了一项为期五年的前瞻性研究，在参与两项正在进行的男性和女性艾滋病毒感染者或艾滋病毒风险队列研究的HCV感染吸毒者中，对丙型肝炎感染的化疗前护理的参与和相关因素进行研究。将在母研究的每半年一次的研究访视中筛选并入组受试者。在每半年一次的研究访问中，研究参与者将接受标准化访谈，以收集人口统计学，性和药物使用行为以及病史的数据，包括肝炎的症状和治疗。此外，将抽取血液进行实验室检测，包括HCV抗体和HCV RNA水平。 这个K23赠款提案的目的是支持这位候选人，因为她发展她的临床研究生涯，并在经验丰富的研究人员的指导下，在HCV感染的吸毒者中进行研究。

DESCRIPTION (provided by applicant): The care of chronic hepatitis C (HCV) infection among drug users, many of whom are co-infected with HIV, is an important public health problem. For drug users with chronic HCV infection, alcohol and active drug abuse, high rates of depression, susceptibility to hepatitis A and B infections, and HIV co-infection are only a few of the variables that affect engagement in and outcome of HCV chemotherapy. Attention to these "pre-chemotherapeutic" factors prepares drug users for future and possibly more efficacious HCV chemotherapy. However, little is known about whether these "pre-chemotherapeutic" factors are successfully addressed in the context of chronic HCV management. The candidate proposes the following specific aims: 1) To determine rates of engagement in pre-chemotherapeutic care among drug users with chronic HCV infection. 2) To determine factors associated with awareness and acceptance of interventions other than specific chemotherapy for reducing the progression of chronic HCV infection and preparing for future chemotherapy. The candidate proposes a five-year prospective study of engagement in and factors associated with pre-chemotherapeutic care for hepatitis C infection, among HCV-infected drug users participating in two ongoing cohort studies of men and women with or at risk for HIV. Participants will be screened and enrolled at a semi-annual research visit for the parent studies. At each semi-annual research visit, study participants will undergo standardized interviews to gather data on demographics, sexual and drug-using behaviors and medical history, including symptoms of and treatment for hepatitis. In addition, blood will be drawn for laboratory assays including HCV antibody and HCV RNA levels. The purpose of this K23 grant proposal is to support this candidate as she develops her clinical research career and undertakes studies in HCV-infected drug users with or at risk for HIV, under the mentorship of experienced investigators.