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直接抗病毒药物时代注射吸毒人群丙型肝炎的抗病毒治疗

Antiviral treatment for hepatitis C among injecting drug users in the era of direct-acting antiviral agents

摘要:

注射吸毒人群(PWID)丙型肝炎病毒感染率高达67%,要实现世界卫生组织2030年消除病毒性肝炎公共卫生威胁的目标,PWID是需要优先关注的人群。尽管丙型肝炎病毒直接抗病毒药物持续病毒学应答可达到95%以上,但是PWID接受治疗仍存在很大的障碍,尤其是在医疗实践中,由于PWID多伴随合并感染、多重基因型感染、低依从性、药物滥用、美沙酮维持治疗、危险行为及再感染等情况,医生常担心这些因素影响疗效而拒绝给PWID提供丙型肝炎治疗。现对不同感染状态及具有特殊行为特征的PWID开展丙型肝炎治疗的情况及效果的有关研究进行综述,结论为在多学科合作下对PWID人群开展的丙型肝炎治疗安全有效并且能保证治疗的依从性。

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abstracts:

HCV prevalence among people who inject drugs (PWID) is up to 67%. PWID is a population that needs priority attention to achieve the World Health Organization's goal of eliminating viral hepatitis as a public health threat by 2030. Although the SVR of HCV patients treated with direct-acting antiviral drugs (DAAs) can reach over 95%, especially in medical practice, there are still major obstacles to PWID treatment, because PWID is usually accompanied with concurrent infection, multiple-genotype infections, low compliance, substance abuse, methadone maintenance therapy, and risky behavior and re-infection conditions. Therefore, physicians often concern that these factors will affect the treatment efficacy, and refuse to provide hepatitis C treatment in PWID. This article reviews the relevant studies status and effects of hepatitis C treatment in PWID with different infection states and special behavior characteristics, and further highlights that the multidisciplinary cooperation for hepatitis C treatment in PWID is safe and effective, and can ensure treatment compliance.

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作者: 潘玲 [1] 庞琳 [1]
期刊: 《中华肝脏病杂志》2020年28卷10期 893-896页 MEDLINEISTICPKUCSCDCA
栏目名称: 综述
DOI: 10.3760/cma.j.cn501113-20200811-000449
发布时间: 2020-11-09
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