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从急诊室查和链接计划中从C型肝炎中持续的病毒学反应:回顾性审查
Lauren A Walter1, Logan Wilson1, Madeline Farmer2
1Department of Emergency Medicine, University of Alabama at Birmingham, Birmingham, AL, United States of America.
The American journal of emergency medicine
|August 4, 2023
概括
紧急部门 (ED) 的查有效地将C型肝炎 (HCV) 患者与直接作用抗病毒药物 (DAA) 治疗联系起来. 虽然链接和DAA启动是成功的,但实现持续的病毒学反应 (SVR) 显示了不同种族和保险群体之间的差异.
科学领域:
- 公共卫生 公共卫生
- 传染性疾病 传染性疾病
- 肝病学 肝病学是一种肝病学.
背景情况:
- 紧急诊所 (ED) 在公共卫生倡议中发挥着至关重要的作用,包括对诸如C型肝炎 (HCV) 等传染病的查.
- 在查后与护理的有效联系对于成功治疗和疾病根除至关重要.
- 直接作用抗病毒药物 (DAA) 彻底改变了HCV治疗方法,导致持续病毒反应 (SVR) 的高率.
研究的目的:
- 评估通过基于ED的HCV查计划确定患者的HCV特异性护理联系率,DAA启动率和SVR成就率.
- 确定与成功链接,治疗和SVR相关的人口和临床因素.
- 评估ED启动的HCV查在实现最终患者结果方面的有效性.
主要方法:
- 从2018年1月到2019年12月,在基于ED的选择退出HCV计划中查的患者的回顾性图表审查.
- 收集的数据包括种族,性别,年龄,保险状况,HCV-RNA阳性,与护理的联系,DAA启动和SVR.
- 使用Pearson的奇方位的双变量分析被用来比较不同人口群体的结果.
主要成果:
- 在66634名被查的人中,有885人 (1.33%) 呈HCV-RNA阳性,其中121人 (13.67%) 与护理相关.
- 在相关患者中,88人 (72.7%) 开始接受DAA治疗.
- 与黑人患者和有保险的人相比,白人患者和没有保险的人更有可能获得SVR (分别为p=0.04和p=0.02).
结论:
- 基于ED的HCV查计划可以成功将患者与护理联系起来,启动DAA治疗,并实现SVR.
- 根据种族和保险状况观察到SVR成就的差异,突出了针对性干预的必要性.
- 了解年龄和保险状况的队列特定差异对于优化DAA治疗坚持和SVR结果至关重要.
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