Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Chuỗi cung cấp chăm sóc viêm gan C trong nhà tù và sau khi ra tù trong thời kỳ điều trị bằng thuốc kháng virus trực tiếp
Tóm tắt
Người có liên quan đến hệ thống tư pháp hình sự đóng góp đáng kể vào gánh nặng viêm gan C virus (HCV) ngày càng gia tăng; tuy nhiên, chuỗi cung cấp chăm sóc là rào cản chính đối với các chương trình trong nhà tù. Chúng tôi nhằm đánh giá một mô hình chăm sóc HCV toàn diện tại một nhà tù tỉnh của Iran. Giữa năm 2017-2018, tại Nhà tù Trung tâm Karaj, các tù nhân nam mới nhập trại đã được xét nghiệm kháng thể HCV và lấy máu tĩnh mạch để xét nghiệm RNA (chỉ những người dương tính với kháng thể). Những người tham gia có RNA dương tính đã được điều trị bằng thuốc kháng virus trực tiếp (DAA) (Sofosbuvir/Daclatasvir). Phản ứng viêm virus duy trì được đánh giá sau 12 tuần điều trị (SVR12). Tổng cộng, từ 3485 người tham gia, có 182 (5,2%) và 117 (3,4%) có kết quả dương tính với kháng thể và RNA HCV, tương ứng. Trong số 116 bệnh nhân đủ điều kiện điều trị, 24% (n=28) bị thả ra trước khi điều trị và 72% (n=83) đã bắt đầu liệu pháp DAA, trong đó 81% (n=67/83) hoàn thành điều trị trong tù, và phần còn lại đã được thả ra. Trong tổng số bệnh nhân đã ra tù, 68% (n=30/44) đã liên kết với chăm sóc tại cộng đồng, và 70% (n=21/30) hoàn thành điều trị, bao gồm 60% (n=12/20) và 90% (n=9/10) trong số những người được thả ra trước và trong quá trình điều trị, tương ứng. Tổng tỷ lệ tiếp nhận và hoàn thành điều trị HCV lần lượt là 89% (n=103/116) và 85% (n=88/103). Từ những người hoàn thành điều trị, 43% (n=38/88) đã đến để đánh giá phản ứng và tất cả đều đã được chữa khỏi (SVR12=100%). Các mô hình chăm sóc HCV tích hợp rất hiệu quả và có thể được củng cố đáng kể bằng các can thiệp sau khi ra tù. Sự hợp tác chặt chẽ giữa hệ thống chăm sóc sức khỏe cộng đồng và nhà tù là điều quan trọng để thúc đẩy mức độ tuân thủ điều trị cao. Các nghiên cứu trong tương lai nên điều tra các yếu tố dự đoán sự tham gia vào chăm sóc HCV sau khi ra tù.
Từ khóa
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