Dataset Information

Continuum of hepatitis C care in France: A 20-year cohort study.

ABSTRACT:

Background

Hepatitis C virus (HCV)-infected patients require a specific continuum of care (CoC) from HCV screening to treatment. We assessed CoC of HCV-infected patients in a longitudinal study.

Methods

We established a cohort of subjects undergoing HCV screening (high alanine aminotransferase levels or risk factors) during preventive consultations at a French regional medical center from 1993 to 2013. Patients were considered to be HCV-infected if HCV RNA was detected in their serum. CoC was assessed as described by Viner et al. (Hepatology 2015): Stage 1, HCV screening; Stage 2, HCV RNA testing; Stage 3, continuing care; Stage 4, antiviral treatment. Cox multivariate analysis was performed to identify factors favoring CoC, defined as at least one course of antiviral treatment.

Results

In total, 12,993 HCV tests were performed and 478 outpatients were found to be HCV-seropositive. We included 417 seropositive patients, after excluding false positives and patients lost to follow-up. The baseline characteristics of the patients were: sex ratio (M/F) 1.4; mean age 38.5 years; intravenous drug use (IDU) in 55%; and 28% in unstable social situations, estimated by the EPICES deprivation score. Antiviral treatment was initiated for 179 (42.9%) of the 379 (90.9%) patients attending specialist consultations. CoC was associated with screening after 1997 (HR 2.0, 95%CI 1.4-2.9), age > 45 years (HR 1.5, 95%CI 1.02-2.3), patient acceptance of care (HR 9.3, 95%CI 5.4-16.10), specialist motivation for treatment (HR 10.9, 95%CI 7.4-16.0), and absence of cancer (HR 6.7, 95%CI 1.6-27.9). Other comorbid conditions, such as depression and IDU, were not associated with CoC.

Conclusions

Our 20-year cohort study reveals the real-life continuum of care for HCV-infected patients in France. The number of patients involved in HCV care after positive testing was substantial due to the organization of healthcare in France. An improved CoC along with new direct-acting antivirals should help to decrease chronic HCV infection.

SUBMITTER: Hermetet C

PROVIDER: S-EPMC5574535 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Publications

Continuum of hepatitis C care in France: A 20-year cohort study.

Hermetet Coralie C Dubois Frederic F Gaudy-Graffin Catherine C Bacq Yannick Y Royer Bernard B Gaborit Christophe C D'Alteroche Louis L Desenclos Jean Claude JC Roingeard Philippe P Grammatico-Guillon Leslie L

PloS one 20170829 8

<h4>Background</h4>Hepatitis C virus (HCV)-infected patients require a specific continuum of care (CoC) from HCV screening to treatment. We assessed CoC of HCV-infected patients in a longitudinal study.<h4>Methods</h4>We established a cohort of subjects undergoing HCV screening (high alanine aminotransferase levels or risk factors) during preventive consultations at a French regional medical center from 1993 to 2013. Patients were considered to be HCV-infected if HCV RNA was detected in their se ...[more]

PMID: 28850623

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Dataset Information

Continuum of hepatitis C care in France: A 20-year cohort study.

Background

Methods

Results

Conclusions

Publications

Continuum of hepatitis C care in France: A 20-year cohort study.

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