米国とカナダで抗レトロウイルス治療を受けているC型肝炎ウイルス (HCV) とHIV感染者の間での直接作用抗ウイルス薬の導入:HCV治療のギャップを牽引する要因
PubMedで要約を見る
まとめ
この要約は機械生成です。ヒト免疫不全ウイルス (HIV) のヒトC型肝炎ウイルス (HCV) に対する直接作用抗ウイルス (DAA) 治療の開始は増加しているが,差異は依然として存在している. 適格な人全員にDAA療法への公平なアクセスを確保するためにさらなる努力が必要である.
科学分野
- 感染症
- ヘパトロジー
- 公衆衛生
背景
- HIV感染者 (PWH) は,C型肝炎ウイルス (HCV) の併感染と健康への悪影響のリスクが高くなります.
- 直接作用の抗ウイルス薬 (DAA) の開始に影響を与える要因を理解することは,PWHにおけるHCVの管理に極めて重要です.
研究 の 目的
- HCV 患者における DAA 発症率を評価する.
- DAAの開始と治療の格差に関連する要因を特定する.
主な方法
- 2014年から2021年まで,検出可能なHCVRNAを有する米国とカナダのPWH (≥18年) のコホートを追跡した.
- DAAの発症の累積的発生率は,競合するリスクモデル (死亡,HCVクリアランス) を用いて推定された.
- コックスの比例リスクモデルは,DAA開始に関連する要因を特定した.
主要な成果
- 6300人のPWHの58%が8年以内にDAA治療を開始し,6%が治療を受けなかった.
- 非ヒスパニックの黒人およびヒスパニックのPWHでは非ヒスパニックの白人のPWHと比較して低かった.
- 発症率の低い要因には,注射薬物使用,リスクの高いアルコール使用,喫煙,検出可能なHIVウイルス病,エイズ病歴が含まれ,より高いFibrosis-4スコアは発症率の増加と関連していた.
結論
- 介護を受ける資格のあるPWHのDAA開始のギャップは縮小しました.
- 公平なDAAの開始を促進し,PWHでHCVの除去を達成するために,ターゲット化された戦略は不可欠です.
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