Treatment of hepatitis C virus infection in Poitou-Charente.

Objectives - The prognosis of hepatitis C virus infection could be improved by early treatment. However this is only possible if most patients with he patitis C consult a specialized institution. The aim of this study was to e valuate the modalities of Care of hepatitis C virus infection in one French district. Methods - Between November and December 1997 89 biological laboratories fro m the "Poitou-Charentes" district were asked to provide results of hepatiti s C virus serology tests performed during this period. A questionnaire conc erning epidemiological and follow-up data was sent to the medical practitio ner who prescribed the test, for all positive tests. Results - Seventy eight out of 89 (88%) laboratories agreed to participate in the study. During the study period, 6,168 subjects were tested and 196 ( 3.2%) were positive. This test was a diagnostic test in 69 cases (53%) and a confirmation test in 61 cases (47%). The epidemiological questionnaire wa s filled out in 130 cases. The main putative factors of viral contamination were: intravenous or nasal drug addiction in 69 cases (53%), blood transfu sion in 39 cases (30%), and a nosocomial risk factor in 16 cases (12%). Tre atment and care of vines infection was evaluated in 113 cases from the foll ow-up questionnaire: a liver biopsy was performed in 30 cases (27%) and int erferon therapy was administered in 13 cases (12%). Liver biopsy was not pe rformed in 83 cases (73%) due to normal transaminase levels ol a contraindi cation to interferon therapy The main causes of an absence of care or follo w-up were: fear of complications of liver biopsy and/or side effects to int erferon therapy (19%), chronic alcoholism (18%) and active drug addiction ( 8%). Conclusion - The main causes of failure to administer adequate care in hepa titis C patients were chronic alcoholism, drug addiction and fear of liver biopsy or side effects of interferon therapy These data should be taken int o account for future screening or information compaigns for the general pop ulation.