COVID-19背景下丙型肝炎患者的重新融合

Gisela Fabiana Sotera, M. Ferreiro, Margarita Martes, Nancy Cordero, Jonathan Salmon, J. Sordá, Jorgelina Daruich, Esteban González Ballerga
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摘要

丙型肝炎病毒感染是全世界发病率和死亡率的主要原因之一。在阿根廷,估计只有50%的感染者得到诊断;在这些患者中,有一半已经确诊,只有5%能够获得治疗。2019冠状病毒病大流行加剧了这种情况,进一步减少了获得治疗的机会。在此背景下,我们制定了一个重新连接和简化患者护理级联的计划,以促进与丙型肝炎病毒感染相关的并发症的诊断、治疗和监测。24.2%的重新参与的患者是治疗的候选者,他们仅在2次医疗咨询中接受了治疗,从首次咨询到提供药物平均时间为29天。我们的研究结果表明,大约一半的丙型肝炎患者没有接受专科医生的随访。在重新参与时有肝硬化的患者中,60%在进入该计划之前有轻度纤维化。超过80%的肝硬化患者不能再参与。需要医疗保健团队作出承诺,以促进减少获得治疗所必需的情况,并制定侧重于教育和评估患者心理社会环境的方案。这将使打破现有的障碍成为可能。
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Revinculación de pacientes con hepatitis C en el contexto de COVID-19
Hepatitis C virus infection is one of the main causes of morbidity and mortality worldwide. In Argentina, it is estimated that only 50% of infected people are diagnosed; of these, half have confirmed their diagnosis, and only 5% have access to treatment. The COVID-19 pandemic has exacerbated this situation, further decreasing access to treatment. In this context, we developed a program to reconnect and simplify the patient care cascade, in order to facilitate access to diagnosis, treatment, and monitoring of complications associated with hepatitis C virus infection. 24.2% of the re-engaged patients were candidates for treatment, and they received it in only 2 medical consultations, with an average time of 29 days between the initial consultation and the delivery of the medication. The results of our study show that approximately half of the patients with hepatitis C are not followed up by a specialist. Of the patients who had cirrhosis at the time of re-engagement, 60% had mild fibrosis prior to admission to the program. More than 80% of patients with cirrhosis could not be re-engaged. A commitment from the healthcare team is required to facilitate the reduction of the instances necessary to access treatment, and programs focused on education and assessment of the patient's psychosocial environment. This will make it possible to break down existing barriers.
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