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Management of hepatitis C patients: a French population-based study
Cyril Hatem1, Anne Minello, Laurent Martin
1EPI INSERM 0106, Centre d'Epidémiologie de Population, Faculté de Médecine, BP 87900, 21079 Dijon Cedex.
Insights
At least one in five hepatitis C patients in the general population do not receive specialized medical care. Management practices for hepatitis C infection vary significantly by gender.
Area of Science:
- Hepatology
- Public Health
- Infectious Diseases
Background:
- Hepatitis C infection requires timely access to specialized medical care for effective management.
- Understanding patient pathways to care is crucial for improving public health outcomes.
Purpose of the Study:
- To determine the proportion of hepatitis C patients accessing specialized medical care post-diagnosis.
- To identify factors influencing access to care and treatment initiation.
Main Methods:
- Analysis of a population-based registry of hepatitis C-positive patients in Cote-d'Or, France (1994-1999).
- Inclusion of 690 eligible patients diagnosed with new hepatitis C serology.
- Assessment of specialized care utilization, including liver biopsy and treatment.
Main Results:
- 135 patients (19.6%) did not receive specialized medical care post-diagnosis.
- Patients outside the healthcare system often had normal liver enzymes, lifestyle risk factors, or alcohol use.
- Among those receiving care, 42.7% underwent liver biopsy and 27.0% were treated.
- Treatment was more common in males and younger patients (<65 years).
Conclusions:
- A significant proportion of hepatitis C patients remain outside the healthcare system.
- Gender influences management practices and treatment initiation.
- Further research is needed to elucidate barriers to care and optimize hepatitis C management strategies.
Aims:
Our aim was to assess the proportion of patients in a well-defined population reaching specialized medical care after hepatitis C diagnosis.
Methods:
Hepatitis C-positive patients recorded in the population-based registry of Cote-d'Or, an administrative district in France, constituted the study population.
Results:
Between 1994 and 1999, new hepatitis C-positive serology was diagnosed in 847 patients, of whom 690 were eligible for this study. A total of 135 patients had not been given specialized medical care after diagnosis; among them, 50.4% had a normal serum alanine transferase level at diagnosis, 62.2% had risk factors related to lifestyle (drug addiction, sexual risk...), and 26.7% were current alcoholics. The 555 other patients were involved in specialized medical care after diagnosis: 42.7% had a liver biopsy and 27.0% were treated. Treatment was carried out more often in males than in females (OR: 1.67; P<0.005), and in patients less than 65 years old (OR: 2.94; P<0.0002). Nearly 30.5% of patients with a Metavir score greater than A1F1 did not undergo treatment.
Conclusion:
This study shows that in a general population at least one patient out of five with hepatitis C infection remains outside the health care system. It also reveals that management practices vary with gender. Further surveys are needed to better understand this phenomenon.
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