VA合并酒精使用障碍和创伤后应激障碍患者丙型肝炎直接抗病毒治疗后饮酒量的变化。

IF 1.5 4区医学 Q3 PSYCHIATRY Journal of Dual Diagnosis Pub Date : 2022-10-01 Epub Date: 2022-09-23 DOI:10.1080/15504263.2022.2123119

Jessica E Hoyt, Nikhil Teja, Tammy Jiang, Luke Rozema, Jiang Gui, Bradley V Watts, Brian Shiner, Jaimie L Gradus

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引用次数: 1

摘要

目的：探讨治疗丙型肝炎病毒感染（HCV）的直接作用抗病毒药物（DAA）：格列卡韦/皮布伦他韦（GLE/PIB）、莱迪帕韦/索非司布韦（LDV/SOF）、，和索非布韦/韦帕他韦（SOF/VEL）与患有酒精使用障碍（AUD）和合并创伤后应激障碍（PTSD）的退伍军人的饮酒量减少有关包括211名患者（GLE/PIB n = 174，LDV/SOF n = 808，SOF/VEL n = 229）。GLE/PIB、LDV/SOF和SOF/VEL的临床意义改善调整频率分别为30.5%、45.5%和40.5%。GLE/PIB的频率低于LDV/SOF（OR = 0.59；95%置信区间[0.40、0.87]）或SOF/VEL（or = 0.66；95%可信区间[0.42，1.04]）。结论：DAA治疗HCV与AUD和合并PTSD患者的酒精使用显著减少有关。有必要进一步探索DAAs在AUD治疗中的作用。

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Changes in Alcohol Consumption following Direct-Acting Antiviral Treatment for Hepatitis C in VA Patients with Comorbid Alcohol Use Disorder and PTSD.

Objective: To investigate whether direct-acting antivirals (DAA) for hepatitis C viral infection (HCV): glecaprevir/pibrentasvir (GLE/PIB), ledipasvir/sofosbuvir (LDV/SOF), and sofosbuvir/velpatasvir (SOF/VEL) are associated with reduced alcohol consumption among veterans with alcohol use disorder (AUD) and co-occurring post-traumatic stress disorder (PTSD).

Methods: We measured change in Alcohol Use Disorder Identification Test-Consumption Module (AUDIT-C) scores in a retrospective cohort of veterans with PTSD and AUD receiving DAAs for HCV.

Results: One thousand two hundred and eleven patients were included (GLE/PIB n = 174, LDV/SOF n = 808, SOF/VEL n = 229). Adjusted frequencies of clinically meaningful improvement were 30.5% for GLE/PIB, 45.5% for LDV/SOF, and 40.5% for SOF/VEL. The frequency was lower for GLE/PIB than for LDV/SOF (OR = 0.59; 95% CI [0.40, 0.87]) or SOF/VEL (OR = 0.66; 95% CI [0.42, 1.04]).

Conclusions: DAA treatment for HCV was associated with a substantial reduction in alcohol use in patients with AUD and co-occurring PTSD. Further exploration of the role of DAAs in AUD treatment is warranted.

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来源期刊

Journal of Dual Diagnosis Multiple-

CiteScore

4.90

自引率

13.60%

发文量

期刊介绍： Journal of Dual Diagnosis is a quarterly, international publication that focuses on the full spectrum of complexities regarding dual diagnosis. The co-occurrence of mental health and substance use disorders, or “dual diagnosis,” is one of the quintessential issues in behavioral health. Why do such high rates of co-occurrence exist? What does it tell us about risk profiles? How do these linked disorders affect people, their families, and the communities in which they live? What are the natural paths to recovery? What specific treatments are most helpful and how can new ones be developed? How can we enhance the implementation of evidence-based practices at clinical, administrative, and policy levels? How can we help clients to learn active recovery skills and adopt needed supports, clinicians to master new interventions, programs to implement effective services, and communities to foster healthy adjustment? The Journal addresses each of these perplexing challenges.