How do general practitioners approach hepatitis C virus screening in France?

To estimate the prevalence of infection by hepatitis C virus (HCV) in gener al practice, and to investigate attitudes to screening for HCV, a specific questionnaire was sent to the sentinel general practitioners (SGPs) of the French Sentinel Network. From the figures reported by SGPs, the number of a nti-HCV tests performed in general practice during the six months before th e survey (July-December 1994) was extrapolated to about 350,000 tests for t he whole of France during all of 1994 (95% CI: 314,000-382,000). Of the 312 participating SGPs, 224 (72%) had prescribed at least one anti-HCV test du ring these six months, and 217 (70%) knew of at least one anti-HCV-positive patient in their practice. With regard to their screening attitudes, 244 S GPs (78%) said they had prescribed anti-HCV tests for patients with no sign s of previous or recent hepatitis infection; SGPs who had at least two HCV- positive patients in their practice were more likely to screen for anti-HCV than SGPs who did not (94% vs. 72% p < 0.001). The main reason for prescri ption were that patients had an anti-HIV-positive status, were intravenous drug users and/or were blood transfusion recipients. For the 88 SGPs who ha d not prescribed any anti-HCV test during the six months before the study, the main reasons given were that few patients were at risk in their practic e (81 SGPs) and that the risk factors for HCV infection were not well known (12 SGPs). Only 6 SGPs gave the absence of effective treatment as a reason for non-prescription. From the figures reported by SGPs, we extrapolated t o 100,000 (95% CI: 90,000-110,000) the number of anti-HCV-positive patients known by the 52,000 French general practitioners in 1994. These results in dicate that the Sentinel network may be a useful tool for assessing the evo lution of attitudes to HCV screening in general practice.