Epidemiological characteristics of hepatitis C in a primary referral hospital. Impact of systematic screening on therapeutic management and natural history

Objectives To study the epidemiological characteristics of patients with ch ronic hepatitis C virus followed in a primary referral hospital and the cli nical influence of "systematic screening" defined as the screening of patie nts without symptoms and with known risk factors of hepatitis C (past trans fusion, past or present intravenous drug use, haemodialysis) on the natural history and treatment of chronic hepatitis C virus. Methods - The files of 311 consecutive patients who screened positive for a nti-hepatitis C virus and were seen at the primary referral hospital, Creil , from January 1992 to February 1996, were analyzed Results-Patients who underwent "systematic screening" were younger with a s horter duration of infection. They were more often intravenous drug addicts and had lower alanine aminotransferase activity and Knodell scores than pa tients who underwent screening during "a diagnostic procedure", because of symptoms and/or abnormal liver biochemistry. increased age at contamination and alcohol consumption of more than 40 g per day was associated with an i ncreased risk of cirrhosis while patients who underwent "systematic screeni ng" had a lower risk of cirrhosis and higher survival rate. Interferon ther apy was attempted less often in anti-hepatitis C virus positive patients fr om "systematic screening" programs. Conclusions - Anti-hepatitis C virus positive patients from "systematic scr eening" programs had a benign disease and were rarely treated with interfer on compared to anti-hepatitis C virus positive patients diagnosed during a "diagnostic procedure".