注射吸毒者对丙型肝炎治疗的了解和态度。

IF 4 2区 社会学 Q1 SUBSTANCE ABUSE
Patrik Roser, Mona Brunstein, Michael Specka, Jörg Timm, Stefan Kühnhold, Fabrizio Schifano, Udo Bonnet, Norbert Scherbaum
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引用次数: 0

摘要

背景:作为治疗丙型肝炎的药物,直接作用抗病毒药物(DAAs)已问世数年,并取代了含干扰素的疗法。然而,在德国,注射吸毒者(PWID)的治疗率正在下降,这使得到 2030 年消除丙型肝炎的目标面临风险。本研究旨在阐明临床样本中的注射吸毒者对丙型肝炎治疗的认识和态度:2019年2月至2020年10月期间,在两家阿片类激动剂治疗(OAT)诊所和两家住院戒毒病房招募了参与者。根据欧洲成瘾严重程度指数(Europ-ASI),对参与者进行了标准化访谈,访谈内容主要包括:社会人口学数据、吸毒史、危险行为、丙型肝炎病毒(HCV)和艾滋病病毒感染情况,以及以往接受 HCV 治疗的经历。此外,参与者还填写了一份调查问卷,其中包括 13 项与丙型肝炎病毒治疗有关的陈述(对/错),以及 15 项关于开始丙型肝炎病毒治疗的个人 "利弊 "观点的陈述,采用 6 点李克特量表进行评估:共调查了 153 名患有阿片类药物使用障碍的患者(平均年龄 45 岁,男性占 78%;106 人(69.3%)目前正在接受阿片类药物维持治疗,47 人(30.7%)目前正在接受住院戒毒治疗)。所有这些患者都表示他们一生中至少注射过一次毒品;97 名参与者(63.3%)表示他们以前曾被诊断感染过丙型肝炎病毒。其中,27/97 名患者(27.8%)称曾接受过干扰素治疗;27/97 名患者(27.8%)称曾接受过 DAAs 治疗;32/97 名患者(33.0%)称目前丙型肝炎处于活动期。然而,高达 50.3% 的患者没有正确评估 DAAs 的低副作用率、短疗程和干扰素替代作用。在 32 名目前处于活动期的丙型肝炎患者中,有 25%-40% 的患者将处理社会和其他医疗问题(如减少使用海洛因)放在了首位,而不是丙型肝炎的治疗:尽管据报道在过去几年中活跃的感染者目前的危险行为水平有所降低,但为提高丙型肝炎治疗率而采取的教育和激励干预措施应弥补患者在知识方面的不足。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Knowledge of, and attitude towards, the treatment of hepatitis C in people who inject drugs.

Background: Direct acting antivirals (DAAs) as a curative treatment of hepatitis C have been available for several years and have replaced interferon-containing therapies. However, treatment rates of people who inject drugs (PWID) are declining in Germany, putting the elimination of hepatitis C by 2030 at risk. This study aimed at elucidating the knowledge of, and attitude towards, hepatitis C treatment in a clinical sample of PWID.

Methods: Participants were recruited between February 2019 and October 2020 at two opioid agonist therapy (OAT) clinics and two in-patient drug detoxification wards. Based on the European Addiction Severity Index (Europ-ASI), a standardized interview focusing on: sociodemographic data, drug history, risky behavior, infection with hepatitis C virus (HCV) and HIV, and previous experience with HCV treatment was carried out. In addition, participants filled in a questionnaire evaluating 13 statements relating to HCV treatment (right/wrong) and 15 statements on their personal 'pros and cons' views to start such a treatment assessed with the means of a 6-point Likert scale.

Results: A total of 153 patients (average age 45 years, male 78%; 106 (69.3%) currently in opioid maintenance treatment, 47 (30.7%) currently admitted to an inpatient detoxification) with an opioid use disorder were investigated. All of them reported having injected drugs at least once in their lives; 97 participants (63.3%) stated that they had been previously diagnosed with HCV infection. Among them, 27/97 patients (27.8%) reported a previous treatment with interferon; 27/97 (27.8%) with DAAs; and 32/97 (33.0%) reported a currently active hepatitis C. Most patients knew about the availability and efficacy of DAAs. However, DAAs' low rate of side effects, their short treatment duration, and their replacement of interferon, were not correctly evaluated by up to 50.3% of patients. 25-40% of 32 patients with currently active hepatitis C prioritized handling of social and other medical issues, e.g., reduction of heroin use, over treatment of hepatitis C.

Conclusions: Although current levels of risky behavior have reportedly been reduced by active PWID over the past few years, educational and motivational interventions to increase hepatitis C treatment uptake should address the gaps in patients' knowledge.

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来源期刊
Harm Reduction Journal
Harm Reduction Journal Medicine-Public Health, Environmental and Occupational Health
CiteScore
5.90
自引率
9.10%
发文量
126
审稿时长
26 weeks
期刊介绍: Harm Reduction Journal is an Open Access, peer-reviewed, online journal whose focus is on the prevalent patterns of psychoactive drug use, the public policies meant to control them, and the search for effective methods of reducing the adverse medical, public health, and social consequences associated with both drugs and drug policies. We define "harm reduction" as "policies and programs which aim to reduce the health, social, and economic costs of legal and illegal psychoactive drug use without necessarily reducing drug consumption". We are especially interested in studies of the evolving patterns of drug use around the world, their implications for the spread of HIV/AIDS and other blood-borne pathogens.
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