Hepatitis C virus burden:Treating and educating people without prejudice  

作　　者：Elettra Merola Elisa Menotti Giovanna Branz Andrea Michielan Sonia Seligmann Annora Ratti Flora Agugiaro Luisa Moser Giovanni Vettori Anna Franceschini William Mantovani Riccardo Pertile Giovanni de Pretis Cecilia Pravadelli 

机构地区：[1]Department of Gastroenterology,Santa Chiara Hospital,Azienda Provinciale Per I Servizi Sanitari(APSS),Trento 38122,Italy [2]Department of SerD,Service for Drug Addiction,Azienda Provinciale Per I Servizi Sanitari(APSS),Trento 38122,Italy [3]Department of Prevention,Azienda Provinciale Per I Servizi Sanitari(APSS),Trento 38122,Italy [4]Department of Clinical and Evaluative Epidemiology,Azienda Provinciale Per I Servizi Sanitari(APSS),Trento 38122,Italy

出　　处：《World Journal of Hepatology》2022年第7期1495-1503,共9页世界肝病学杂志（英文版）（电子版）

摘　　要：Hepatitis C virus(HCV)infection has a worldwide incidence of 1.1%.In Italy,60%of people who inject drugs(PWIDs)and are receiving assistance for substance use disorder are infected with HCV.However,this subset of patients has extremely limited access to care due to multiple factors,including alcohol abuse,psychological comorbidities,and homeless status.AIM To describe the impact of our HCV-dedicated service for substance use disorder(SSUD)service on PWIDs receiving anti-HCV therapy.METHODS A dedicated,multidisciplinary team was set up at the SSUD of Trento in October 2020 to provide antiviral treatment to HCV RiboNucleic Acid-positive patients with an active or previous history of substance abuse.The treatment was followed by a health education program.Patients were treated with Direct-Acting Antivirals(DAAs).Data were retrospectively analyzed to assess the efficacy of our dedicated program in terms of therapy completion,HCV eradication,and compliance(primary endpoint).The rate of HCV reinfection and DAA-related toxicity were also assessed(secondary endpoints).RESULTS A total of 40 patients were enrolled in the study:28(70.0%)were treated with Sofosbuvir/Velpatasvir,while 12(30.0%)received Glecaprevir/Pibrentasvir.At the time of inclusion in the study,36 patients were receiving opioid agonist maintenance therapy,whilst another 4 had just finished the treatment.37.5%had a history of alcoholism and 42.5%received concomitant psychiatric treatment.All 40 patients(100.0%)completed the therapy cycle and 92.5%of patients adhered to the program.All patients tested negative for viral load at the end of the treatment.There were no significant drug interactions with common psychiatric treatments and no side effects were observed.The sustained virological response was achieved in 92.5%of cases with good tolerability,although two patients discontinued treatment temporarily.After HCV eradication,one patient died from an overdose,another from complications of cirrhosis,and one reinfection occurred.CONCLUSION Very high adherence

关 键 词：Hepatitis C virus Service for substance use disorder Direct-acting antivirals Sustained virologic response COMPLIANCE TOLERABILITY 

分 类 号：R512.63[医药卫生—内科学]