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Published on: June 5, 2020
[A pluridisciplinary point of view of hepatitis C virus infections]
Philipe Halfon1, Denis Ouzan, Laurent Cattan
1Département de virologie, Laboratoire Alphabio, Marseille. alphabio@wanadoo.fr
Insights
Effective hepatitis C virus (HCV) infection management requires collaboration among healthcare professionals. Key questions involve screening, diagnostic tests like RNA HCV, and post-treatment follow-up.
Area of Science:
- Hepatology
- Infectious Diseases
- Clinical Management
Context:
- Hepatitis C virus (HCV) infection management involves a multidisciplinary approach.
- Coordination between virologists, general practitioners, hepato-gastroenterologists, and hospital residents is essential.
- The biologist's role is critical in diagnostic testing (RNA HCV), prognosis, and guiding therapeutic strategies (genotyping, Fibrotest, Actitest).
Purpose:
- To outline the collaborative roles of various healthcare professionals in managing HCV infections.
- To emphasize the importance of integrated care pathways for optimal patient outcomes.
- To address key questions regarding screening, diagnostic workup, and follow-up for HCV.
Summary:
- General practitioners are integral throughout the management process, including recognizing and managing co-existing conditions.
- Hepatologists and general practitioners are key partners, with specialists focusing on patients undergoing treatment.
- Essential considerations include screening criteria, diagnostic investigations post-serology, and comprehensive follow-up protocols during and after anti-HCV therapy.
Impact:
- Improved patient care through coordinated multidisciplinary efforts in HCV management.
- Enhanced diagnostic accuracy and therapeutic decision-making by leveraging specialist expertise.
- Clearer guidelines for screening, workup, and follow-up, potentially leading to better treatment outcomes and reduced HCV transmission.
Abstract:
Various complementary actors are implied in the management of HCV infections: virologists, general practitioners, hepato-gastroenterologists and hospital residents, and they should all cooperate together. The role of biologist is crucial in assisting the practitioners in the choice of examinations to be prescribed for the diagnosis of HCV infections (search for RNA HCV), in establishing a prognosis and in deciding on the therapeutic strategy (genotyping, Fibrotest and Actitest). The role of the general practitioner is important at all stages of the management. The practitioner's involvement is also crucial in the recognition and follow-up of the concomitant diseases. THE ROLE OF THE SPECIALIST: The hepatologist, together with the general practitioner, are inseparable partners in the management of a patient suffering from hepatitis C. The specialist should only see patients exhibiting hepatitis C who are participating in a treatment program, since the indication for treatment is usually decided on by the specialist. The hepatologist should be informed of the various concomitant diseases and the treatments (replacement therapy or others) prescribed for them. CRUCIAL QUESTIONS: For the management of an HCV infection, in general 3 questions require an answer: who should be screened for such infections, what explorations should be performed in the case of positive serology and what follow-up is required during and after anti-HCV treatment?
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