[frontline-hepatitis-awareness] Is the management of hepatitis C patients appropriate? A population-based study

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Alimentary Pharmacology & Therapeutics

Volume 21 Issue 8 Page 1007 - April 2005

doi:10.1111/j.1365-2036.2005.02393.x

Is the management of hepatitis C patients appropriate? A population-based

study

C. Hatem*, A. Minello*, S. Bresson-Hadni, V. Jooste*, P. Evrard, B. Obert,

C. Lepage*, C. Bonithon-Kopp*, J. Faivre*, E. Monnet, J.-P. Miguet, P.

Hillon* & The Rebohc and Revhoc Committees

Summary

Background: In order for hepatitis C patients to receive antiviral

treatment, they must reach medical care.

Aim: To assess the proportion of patients reaching medical care after

hepatitis C diagnosis in a general population (1 006 171 inhabitants) in

France.

Methods: Between 1994 and 1999, 1508 cases were diagnosed, of which 1251

were eligible for the study.

Results: Two-hundred and two patients did not have any medical care; among

them, 55.4% had normal alanine transferase, 58.4% had risk factors related

to lifestyle and 22.8% were alcoholics. Amongst the 1049 other patients,

41.6% had a liver biopsy, 25.0% were treated. Treatment was more often

carried out in males than in females (OR: 1.59; P = 0.001), and in patients

under 65 than in older patients (OR: 2.22; P < 0.008). Among non-treatment

reasons, alcoholism (P = 0.001), drug-addiction (P = 0.04) and escaping

monitoring (P = 0.04) were more frequent in males than in females, whereas

normal alanine transferase was more frequent in females than in males (P =

0.004). Amongst 278 patients with a Metavir score >A1F1, 71 (25.5%) did not

undergo treatment.

Conclusion: In a general population, one patient in six did not receive

on-going health care; a quarter of patients with a Metavir score >A1F1 did

not receive any treatment. These results showed insufficient clinical

management, which could compromise the effectiveness of treatment in general

population.