The efficacy of integrated hepatitis C virus treatment in relieving fatigue in people who inject drugs: a randomized controlled trial.

IF 3 3区 医学 Q2 SUBSTANCE ABUSE Substance Abuse Treatment, Prevention, and Policy Pub Date : 2023-04-24 DOI:10.1186/s13011-023-00534-1
Jørn Henrik Vold, Fatemeh Chalabianloo, Else-Marie Løberg, Christer F Aas, Aaron G Lim, Peter Vickerman, Kjell Arne Johansson, Lars Thore Fadnes
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Abstract

Background: Most people who inject drugs (PWIDs) suffer from severe fatigue, and chronic hepatitis C virus (HCV) infection may play a role in this. However, there is scarce evidence about interventions that alleviate fatigue among PWIDs. The present study investigated the effect of integrated HCV treatment on fatigue in this population compared to the effect of standard HCV treatment, adjusted for sustained virological response of the HCV treatment.

Methods: This multi-center, randomized controlled trial evaluated fatigue as a secondary outcome of integrated HCV treatment (the INTRO-HCV trial). From May 2017 to June 2019, 276 participants in Bergen and Stavanger, Norway, were randomly assigned to receive integrated and standard HCV treatment. Integrated treatment was delivered in eight decentralized outpatient opioid agonist therapy clinics and two community care centers; standard treatment was delivered in specialized infectious disease outpatient clinics at referral hospitals. Fatigue was assessed prior to treatment and 12 weeks after treatment using the nine-item Fatigue Severity Scale (FSS-9). We applied a linear mixed model to evaluate the impact of integrated HCV treatment on changes in FSS-9 (ΔFSS-9) sum scores.

Results: At baseline, the mean FSS-9 sum score was 46 (standard deviation (SD): 15) for participants on integrated HCV treatment and 41 (SD: 16) for those on standard treatment. Twelve weeks after completed HCV treatment, the mean FSS-9 sum score for participants receiving integrated HCV treatment was 42 (SD: 15) and 40 (SD: 14) for those receiving standard HCV treatment. Integrated HCV treatment did not reduce the FSS-9 scores compared to standard HCV treatment (ΔFSS-9: -3.0, 95% confidence interval (CI): -6.4;0.4).

Conclusions: Fatigue is a common symptom among PWIDs. Integrated HCV treatment is at least equal to standard HCV treatment in improving fatigue.

Trial registration: ClinicalTrials.gov.no NCT03155906, 16/05/2017.

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丙型肝炎病毒综合治疗缓解注射吸毒者疲劳的疗效:一项随机对照试验
背景:大多数注射吸毒者(PWIDs)患有严重的疲劳,慢性丙型肝炎病毒(HCV)感染可能在其中起作用。然而,很少有证据表明干预措施可以缓解pwid患者的疲劳。本研究调查了HCV综合治疗对该人群疲劳的影响,与标准HCV治疗的效果进行了比较,并根据HCV治疗的持续病毒学反应进行了调整。方法:这项多中心、随机对照试验评估了疲劳作为HCV综合治疗的次要结局(INTRO-HCV试验)。从2017年5月到2019年6月,挪威卑尔根和斯塔万格的276名参与者被随机分配接受综合和标准的HCV治疗。在8个分散的门诊阿片受体激动剂治疗诊所和2个社区护理中心提供综合治疗;在转诊医院的传染病专科门诊提供标准治疗。采用9项疲劳严重程度量表(FSS-9)评估治疗前和治疗后12周的疲劳程度。我们采用线性混合模型来评估综合HCV治疗对FSS-9 (ΔFSS-9)总评分变化的影响。结果:在基线时,HCV综合治疗组的FSS-9平均总分为46分(标准差(SD): 15),标准治疗组的FSS-9平均总分为41分(SD: 16)。完成HCV治疗12周后,接受综合HCV治疗的参与者的FSS-9平均总得分为42 (SD: 15),接受标准HCV治疗的参与者的FSS-9平均总得分为40 (SD: 14)。与标准HCV治疗相比,HCV综合治疗并未降低FSS-9评分(ΔFSS-9: -3.0, 95%可信区间(CI): -6.4;0.4)。结论:疲劳是PWIDs患者的常见症状。综合丙型肝炎治疗在改善疲劳方面至少与标准丙型肝炎治疗相同。试验注册:ClinicalTrials.gov.no . NCT03155906, 16/05/2017。
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来源期刊
CiteScore
5.20
自引率
0.00%
发文量
73
审稿时长
19 weeks
期刊介绍: Substance Abuse Treatment, Prevention, and Policy is an open access, peer-reviewed journal that encompasses research concerning substance abuse, with a focus on policy issues. The journal aims to provide an environment for the exchange of ideas, new research, consensus papers, and critical reviews, to bridge the established fields that share a mutual goal of reducing the harms from substance use. These fields include: legislation pertaining to substance use; correctional supervision of people with substance use disorder; medical treatment and screening; mental health services; research; and evaluation of substance use disorder programs.
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