Adherence to HCV Treatment in HCV and HCV/HIV Patients

描述(由申请者提供)：NIMH指导的以患者为导向的职业发展奖(K23)的申请题为“在丙型肝炎病毒和丙型肝炎病毒/艾滋病毒患者中坚持丙型肝炎病毒治疗”，旨在将临床心理学家首席调查员(PI)培养成一名独立的调查员，对患有精神疾病和药物使用障碍的非依从性内科疾病患者进行研究。毒品和犯罪问题办公室的短期职业目标包括：(1)丙型肝炎病毒和艾滋病毒感染的诊断和治疗知识；(2)遵守情况的测量和不遵守的生物后果的知识；(3)与药物滥用有关的问题和艾滋病毒/丙型肝炎病毒和药物滥用的神经认知方面的培训；(4)研究方法、统计、赠款编写方面的培训；(5)关于(前)注射吸毒者研究的公共卫生和政策方面的培训；(6)进行伦理研究的培训；(7)管理有条理的精神病学面谈时间表的培训。该中心的长期目标包括研究并存的医疗和精神疾病对坚持接受治疗的影响，特别是对丙型肝炎病毒和丙型肝炎病毒/艾滋病毒患者。提出的这项研究是一项前瞻性队列研究，其中100名丙型肝炎病毒患者和100名丙型肝炎病毒/艾滋病毒患者将在开始使用聚乙二醇化干扰素-阿尔法和利巴韦林(聚乙二醇化干扰素/RBV)治疗丙型肝炎病毒之前登记。使用聚乙二醇化干扰素/RBV治疗与许多血液学、生理和神经精神方面的副作用有关，这导致早期停止治疗的比率很高。在治疗的头24周，将对200名招募的患者进行跟踪，以确定抑郁、神经认知功能、药物滥用和治疗自我效能是否与这两组患者的早期停止治疗有关，以及这两组患者的早期停止治疗率是否不同。这项研究的结果将对制定干预措施以支持和协助丙型肝炎病毒和丙型肝炎病毒/艾滋病毒患者完成其聚乙二醇化干扰素/RBV治疗具有重要意义。

DESCRIPTION (provided by applicant): This application for an NIMH Mentored Patient-Oriented Career Development Award (K23), titled "Adherence to HCV Treatment in HCV and HCV/HIV Patients," seeks to develop the Principal Investigator (PI), a clinical psychologist, into an independent investigator performing research with nonadherent medically ill patients with comorbid psychiatric and substance use disorders. The short-term career goals of the PI include obtaining (1) knowledge of the diagnosis and treatment of HCV and HIV infections, (2) knowledge of the measurement of adherence and of the biological consequences of non-adherence, (3) training in substance abuse-related issues and neurocognitive aspects of HIV/HCV and substance abuse (4) training in research methodology, statistics, grant writing (5) training in public health and policy aspects of research on (former) injection drug users, (6) training in the conduct of ethical research, (7) training in the administration of structured psychiatric interview schedules. The long-term goals of the PI include conducting research on the impact of comorbid medical and psychiatric conditions on adherence to medical treatment, particularly with HCV and HCV/HIV patients. The research proposed is a prospective cohort study in which 100 HCV and 100 HCV/HIV patients will be enrolled just prior to initiating HCV therapy with pegylated IFN-alfa and ribavirin (PEG-IFN/RBV). Treatment with PEG-IFN/RBV is associated with numerous hematologic, physical, and neuropsychiatric side effects, which lead to high rates of early treatment discontinuation. The 200 recruited patients will be followed for the first 24 weeks of treatment to determine whether depression, neurocognitive functioning, substance abuse and treatment self-efficacy are associated with early treatment discontinuation in these two groups of patients and whether the two groups differ in rates of early treatment discontinuation. The findings of this study will have important implications for the development of interventions to support and assist HCV and HCV/HIV patients in completing their course of PEG-IFN/RBV treatment.