背景:在一般实践中,对患有丙型肝炎(HCV)的静脉吸毒者(IDU)的护理超出了阿片类药物替代疗法。在一般实践中,与诊断和治疗结果相关的HCV服务利用的汇总分析仍然未知。
目的:本研究旨在评估HCV的患病率,并分析在一般情况下有静脉用药史的HCV患者的诊断和治疗相关结果的相关数据。
方法:一般实践中的系统综述和荟萃分析。
方法:这篇综述包括发表在以下数据库中的研究:EMBASE,PubMed,和Cochrane中央控制试验登记册。两名审阅者在Covidence中以标准形式独立提取数据。使用DerSimonian和Laird随机效应模型进行了荟萃分析,该模型具有方差反加权。
结果:共有来自440个一般实践的20,956名患者参加了18个选定的研究。对15项研究的荟萃分析显示,46%(95%置信区间(CI),26-67%)注射吸毒者中丙型肝炎的患病率。4项研究提供了基因型信息,11项研究提供了治疗相关结果。总的来说,治疗吸收率为9%,治愈率为64%(95%CI,43-83%)。然而,相关信息,例如特定的治疗方案,治疗持续时间和剂量,和病人的合并症,在这些研究中记录不佳。
结论:在一般实践中,注射吸毒者中HCV的患病率为46%。只有10项研究报告了与HCV相关的治疗结果;然而,总吸收率低于10%,治愈率为64%。同样,HCV诊断的基因型变异,药物类型,剂量报告不佳,建议需要在该患者组中对这方面的护理进行进一步研究,以确保最佳的治疗结果。
The care provided in general practice to intravenous drug users (IDUs) with hepatitis C (HCV) extends beyond opioid substitution therapy. An aggregated analysis of HCV service utilization within general practice specifically related to diagnosis and treatment outcomes remains unknown from previous literature.
This study aims to estimate the prevalence of HCV and analyze data related to the diagnosis and treatment-related outcomes of HCV patients with a history of intravenous drug use in the general practice setting.
A systematic review and meta-analysis in general practice.
This review included studies published in the following databases: EMBASE, PubMed, and Cochrane Central Register of Controlled Trials. Two reviewers independently extracted data in standard forms in Covidence. A meta-analysis was done using a DerSimonian and Laird random-effects model with inverse variance weighting.
A total of 20,956 patients from 440 general practices participated in the 18 selected studies. A meta-analysis of 15 studies showed a 46% (95% confidence interval (CI), 26-67%) prevalence rate of hepatitis C amongst IDUs. Genotype information was available in four studies and treatment-related outcomes in 11 studies. Overall, treatment uptake was 9%, with a cure rate of 64% (95% CI, 43-83%). However, relevant information, such as specific treatment regimens, treatment duration and doses, and patient comorbidities, was poorly documented in these studies.
The prevalence of HCV in IDUs is 46% in general practice. Only ten studies reported HCV-related treatment outcomes; however, the overall uptake rate was below 10%, with a cure rate of 64%. Likewise, the genotypic variants of HCV diagnoses, medication types, and doses were poorly reported, suggesting a need for further research into this aspect of care within this patient group to ensure optimal treatment outcomes.