樂痛結核個案之治療與防治

Treatment and Prevention of Tuberculosis among Injection Drug Users

藥癮者是結核感染之高危險群；藥癮族群在許多國家甚引起結核病流行。因此，針對藥癮者結核感染早期診斷與治療是需要的。新診斷方法包括丙型干擾素分析（Interferon-7-release assays；IGRAs）可以改善藥癮者結核感染之診斷與監視；然而藥癮者接受結核感染監視與預防性治療之順從性仍偏低；這主要與藥癮者接受醫療處置順從性低與藥癮族群各種特殊社會行為有關。因此若針對藥癮結核個案實施都治治療，可以改善藥癮結核個案治療之順從性。

Injection drug users are at an increased risk for infection with Mycobacterium tuberculosis. Drug users, particularly the injection-drug users, have driven tuberculosis (TB) epidemics in several countries. Therefore, the early identification and treatment of TB among injection drug users is required. New diagnostic techniques, including interferon- r -release assays, offer the potential for improved diagnosis and surveillance of injection drug users. However, the percentage of patients completing the screening process and, more importantly, the course of preventive treatment has generally been low. This may partly be because injection drug users, who have many sociobehav-ioral problems, generally do not adhere to the medical interventions. The strategies that incorporate the use of directly observed therapy with treatment for drug abuse with TB infection are recommended.