Pre-Chemotherapeutic Care of HCV Infected Drug Users

描述(由申请人提供)： 在吸毒者中护理慢性丙型肝炎(HCV)感染是一个重要的公共卫生问题，其中许多吸毒者与艾滋病毒合并感染。对于慢性丙型肝炎病毒感染的吸毒者，酒精和活跃的药物滥用，抑郁的高比率，对甲型和乙型肝炎的易感性，以及艾滋病毒的混合感染，只是影响丙型肝炎病毒化疗的参与和结果的几个变量。对这些“化疗前”因素的关注使吸毒者为未来以及可能更有效的丙型肝炎病毒化疗做好准备。然而，这些“化疗前”因素在慢性丙型肝炎治疗中是否得到了成功的解决，人们知之甚少。 候选人提出了以下具体目标： 1)了解慢性丙型肝炎病毒感染者对化疗前护理的参与率。 2)了解和接受除特定化疗外的干预措施，以减少慢性丙型肝炎病毒感染的进展，并为未来的化疗做准备。 候选人提出了一项为期五年的前瞻性研究，在丙型肝炎病毒感染的吸毒者中参与丙型肝炎病毒感染的化疗前护理及其相关因素，这些吸毒者参与了两项正在进行的关于艾滋病毒携带者和女性的队列研究。参与者将在每半年一次的家长研究访问中进行筛选和登记。在每半年一次的研究访问中，研究参与者将接受标准化的访谈，以收集有关人口统计学、性行为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，还将抽取血液进行实验室检测，包括丙型肝炎病毒抗体和丙型肝炎病毒核糖核酸水平。 这项K23拨款提案的目的是支持这位候选人在有经验的研究人员的指导下，发展她的临床研究事业，并在患有艾滋病毒或有艾滋病毒风险的丙型肝炎病毒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.