Directly observed therapy for chronic hepatitis C: A randomized clinical trial in the prison setting / Tratamiento directamente observado de la hepatitis C crónica: un ensayo clínico aleatorizado en el ámbito penitenciario
Gastroenterol. hepatol. (Ed. impr.)
; 37(8): 443-451, oct. 2014.
Artigo
em Inglês
| IBECS
| ID: ibc-127290
Biblioteca responsável:
ES1.1
Localização: BNCS
ABSTRACT
BACKGROUND:
The diagnosis and treatment of chronic hepatitis C are major concerns in prisons.OBJECTIVES:
The aim of this randomized clinical trial was to determine the extent to which directly observed therapy (DOT) improved the efficacy of the standard treatment for chronic hepatitis C in the prison setting. PATIENTS ANDMETHODS:
A randomized clinical trial was carried out to evaluate the efficacy of a DOT compared with a self-administered therapy in prison inmates who underwent standard treatment for chronic hepatitis C (based on pegylated interferon alpha-2a and ribavirin).RESULTS:
A total of 252 inmates were randomized, of which 244 were analyzed 109 in the DOT group and 135 in the non-DOT group. The mean age was 35.88 years (SD 6.54), 94.3% were men, 72.1% reported intravenous drug use, 21.3% were HIV co-infected, and 55.3% had genotype 1 or 4. The patients received the study treatment for a median time of 33.9 weeks in the overall sample. Sustained virological response was achieved in 60.6% (95% CI, 51.17-69.22) of the DOT group and in 65.9% (95% CI, 57.59-73.38) of the standard therapy group (risk ratio = 0.92; 95% CI, 0.76-1.12). The mean proportion of patients continuing the treatment was 83% (SD = 31). Adverse events were reported in 93.4% of the patients, and serious adverse events were reported in 8.2%, with no significant differences between groups.CONCLUSIONS:
Sustained virological response was remarkably high, although there were no differences between groups, probably due to high treatment adherenceRESUMEN
ANTECEDENTES El diagnóstico y tratamiento de la hepatitis C crónica son una preocupación importante en los centros penitenciarios. OBJETIVOS:
El propósito de este ensayo clínico aleatorizado fue determinar hasta qué punto el tratamiento directamente observado (TDO) mejoraba la eficacia del tratamiento estándar para la hepatitis C crónica en el ámbito penitenciario. PACIENTES YMÉTODOS:
Ensayo clínico aleatorizado para evaluar la eficacia del TDO comparado con el tratamiento auto-administrado en internos que reciben régimen estándar para la hepatitis C crónica (interferón pegilado alfa-2a y ribavirina).RESULTADOS:
Se aleatorizaron un total de 252 sujetos, de los cuales se analizaron 244 109 el grupo TDO y 135 en el grupo no-TDO. La media de edad fue 35,88 (DE 6,54), 94,3% eran hombres,72,1% eran usuarios de drogas intravenosas, 21,3% co-infectados con HIV y 55,3% tenían genotipo1 o 4. En la muestra global, los pacientes recibieron el tratamiento del estudio durante una mediana de tiempo de 33,9 semanas. La respuesta virológica sostenida fue llamativamente elevada, aunque no hubo diferencias entre grupos, probablemente debido a la elevada adherencia al tratamiento en las dos ramas (AU)
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Espanha
Contexto em Saúde:
ODS3 - Saúde e Bem-Estar
Problema de saúde:
Meta 3.3: Acabar com as doenças tropicais negligenciadas e combater as doenças transmissíveis
Base de dados:
IBECS
Assunto principal:
Ribavirina
/
Interferons
/
Hepatite C Crônica
/
Terapia Diretamente Observada
Tipo de estudo:
Ensaio clínico controlado
/
Estudo observacional
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Gastroenterol. hepatol. (Ed. impr.)
Ano de publicação:
2014
Tipo de documento:
Artigo
Instituição/País de afiliação:
Centro Penitenciario Barcelona Hombres/Spain
/
Centro Penitenciario Fontcalent/Spain
/
Centro Penitenciario/Spain
/
Universidad Miguel Hernández/Span