Effects of Recent IV Drug Use and Severity of Psychiatric Symptoms to Antiviral Treatment in People Who Inject Drugs

Yıl 2023, , 12 - 21, 31.03.2023

Sercan Karabulut

https://doi.org/10.51982/bagimli.1105469

Öz

Objective: People who inject drugs have major contribution to a rise in hepatitis C virus (HCV) infections. Despite efficacy and safety of direct-acting antiviral (DAA) therapies, patients may have difficulties to receive treatment. In this study we aimed to examine the effect of clinical variables in substance users to access to antiviral treatment and the treatment rate.
Method: In this retrospective study, we examined the files of 5586 patients who admitted to Outpatient Treatment Center (OTC) between July 2020-April 2021 and files of 121 patients with positive Anti-HCV results were included. All patients had been routinely assessed by Addiction Profile Index (API) and Adult Attention Deficit Hyperactivity Disorder Self-Rating Scale (ASRS)..
Results: Of 121 patients, the most used substance was opiate. Because of the insurance restrictions, DAA treatment might be prescribed in only tertiary referral hospitals. All patients had been referred to a tertiary referral hospital. The mean duration from Anti-HCV testing to treatment was 190.3 days. Actively iv substance users were more likely to use substances every day ( 81.5 % vs 41.5%), start using the current substance at younger age (19.1 vs 20.9), have higher total API scores, have higher depression (4.7 vs 3.7), anxiety subscale scores, and ASRS-A scores (11.3 vs 8.3). Actively iv substance users were no more likely to have longer Anti-HCV – treatment duration (100.4 ve 254.5) and have worse treatment completion rates (% 100 vs 67.7).
Conclusion: According to research findings, young adults' expectations to obtain social status and social conformity through the acquisition of a product may affect spending time for online shopping and they may lose control of the use of credit cards.

Anahtar Kelimeler

Hepatitis C; Substance; Intravenous; Opiate

Damar Yoluyla Madde Kullananlarda Son Dönemde IV Madde Kullanımının ve Psikiyatrik Belirti Şiddetinin Antiviral Tedaviye Etkisi

Öz

Amaç: Damar içi madde kullanan kişilerin hepatit C virüsü (HCV) enfeksiyonlarındaki artışa büyük katkısı vardır. Doğrudan etkili antiviral (DEA) tedavilerin etkinliği ve güvenliğine rağmen, hastalar tedaviye ulaşmakta zorluk çekebilirler. Bu çalışmada madde kullanıcılarında klinik değişkenlerin antiviral tedaviye erişim ve tedavi oranlarına etkisini incelemeyi amaçladık.
Yöntem: Bu retrospektif çalışmada Temmuz 2020-Nisan 2021 tarihleri arasında Ayaktan Arındırma Merkezi'ne (AAM) başvuran 5586 hastanın dosyası tarandı, Anti-HCV pozitif çıkan 121 hastanın dosyası incelenmiş ve eksik veri bulunan dosyalar dahil edilmemiştir. Tüm hastaların geçmişte Bağımlılık Profil İndeksi (BAPİ) ve Yetişkin Dikkat Eksikliği Hiperaktivite Bozukluğu Kendini Değerlendirme Ölçeği (ASRS) sonuçları rutin olarak mevcuttu.
Bulgular: Hastaların en çok kullandığı madde opiyattı. Sigorta kısıtlamaları nedeniyle, DEA tedavisi yalnızca üçüncü basamak hastanelerde reçete edilebildiğinden, çalışmaya alınan tüm hastalar üçüncü basamak bir hastaneye sevk edilmişti. Anti-HCV tarama testinden antiviral tedaviye kadar geçen ortalama süre 190,3 gündü. Aktif iv madde kullanıcılarının her gün madde kullanma oranı daha yüksek (%81,5 e %41,5), mevcut maddeyi daha genç yaşta kullanmaya başlama oranları (%19,1 e %20,9) ve toplam BAPİ puanları daha yüksek, depresyon (4,7 e 3,7, p=0,022), anksiyete alt ölçek puanları ve ASRS-A puanları daha yüksekti (11,3 e 8,3). Aktif iv madde kullanıcılarını ile hayat boyu iv kullanıcıları karşılaştırıldığında, Anti-HCV testi – tedavi süresi (100,4 ve 254,5) ve antiviral tedaviyi tamamlama oranları açısından fark yoktu (%100 e %67,7).
Sonuç: Yüksek tedavi oranlarını gösteren kapsamlı verilere rağmen, iv madde kullanıcıları için tedavi oranları kabul edilebilir olmaktan uzak görünmektedir. Aktif damar içi madde kullanan kişileri ayrıştıran faktörlerin analizi iv kullanımı sonlandırmak açısından önem taşısa da, antiviral tedavi kararı geciktirilmemelidir.

Anahtar Kelimeler

Hepatit C, İntravenöz, Opiyat, Madde

Kaynakça

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