PDF(Pubmed)
Abstract：
This quality improvement (QI) project provided Hepatitis C virus (HCV) treatment at a Federally Qualified Health Clinic (FQHC) for persons who use illicit drugs. Many of these individuals sought treatment at the local Infectious Disease (ID) clinic but were denied care as they require a patient be drug-free for 6 months prior to HCV treatment. These individuals expressed a desire to be cured of HCV, which can lead to liver failure or cirrhosis if left untreated. This project bridged the existing gap in HCV treatment that currently exists for substance-users in this city. Pre-treatment HCV levels were obtained from 20 participants who completed an 8-week daily regimen of Mavyret, a direct-acting antiviral (DAA) agent, prescribed by a primary care Nurse Practitioner (NP), trained to treat HCV. Pre-treatment HCV loads were compared to the sustained viral load, obtained 12 weeks post-treatment (SVR-12), which is considered the \"test of cure.\" The results indicate that 100% of returning patients were considered cured of HCV. This program successfully integrated HCV treatment at a community health center, in a population affected by substance use. Adoption of similar programs in primary care clinics can help meet the clinical needs of this often stigmatized and vulnerable population as well as cure them of HCV.
摘要：
这项质量改进（QI）项目在联邦合格健康诊所（FQHC）为使用非法药物的人提供了丙型肝炎病毒（HCV）治疗。这些个体中的许多人在当地传染病(ID)诊所寻求治疗,但被拒绝治疗,因为他们要求患者在HCV治疗之前6个月不使用药物。这些人表达了治愈HCV的愿望，如果不及时治疗，可能导致肝功能衰竭或肝硬化。该项目弥合了目前在HCV治疗方面存在的差距，该差距目前在该市的药物使用者中存在。治疗前的HCV水平来自20名参与者，他们完成了为期8周的每日Mavyret治疗方案，直接作用的抗病毒（DAA）剂，由初级保健护士从业者（NP）规定，受过治疗HCV的训练。将治疗前的HCV载量与持续的病毒载量进行比较，治疗后12周获得（SVR-12），这被认为是治愈的测试。“结果表明，100%的返回患者被认为是HCV治愈。该计划成功地在社区卫生中心整合了HCV治疗，在受物质使用影响的人群中。在初级保健诊所采用类似的计划可以帮助满足这种经常受到污名化和脆弱人群的临床需求，并治愈他们的HCV。
