[Evaluation of three testing strategies for detection of hepatitis C in a hospital medical consultation and in an HIV testing center].
OBJECTIVE
Testing for hepatitis C virus (HCV) is recommended. The purpose of this study was to evaluate the efficacy of HCV testing in a medical consultation without an appointment and in an HIV testing center based on three testing strategies: 1997 French Consensus Conference, "Lettre de la Direction Générale de la Santé" (January 1996), and extension to other risk factors.


METHODS
For 6 months a free blood test was offered to any patient with a risk factor according to the literature.


RESULTS
There were 1 736 new patients at the medical consultation and 1 616 at the testing center. The patients were younger at the testing center than at the medical consultation (31.1 vs 43.3 years; P<0.001). Acceptance of screening was better at the testing center (97.8% vs 75.2%; P<0.001). There were more patients exposed to one of the risk factors at the testing center (31.2% vs 13.9%; P<0.001). Tests were more efficient at the testing center: 30 HCV positive patients/1 616 (1.86%) vs 11/1 736 (0.63%, P<0.01). Tests based on the 1997 French Consensus Conference provided detection in 27/30 (90%) of HCV positive patients at the testing center but only 4/11 (36.3%) at the medical consultation (P<0.01).


CONCLUSIONS
Testing was effective in both places but was more efficient at the testing center. Efficacy of the testing strategies differs significantly according to the place of screening. At the testing center, screening can be restricted to patients with a history of intravenous drug use and blood transfusion. At the medical consultation, screening should be extended to other risk factors.
Aparicio
T
T
Service d'Hépato-Gastroentérologie, Hôpital Bichat-Claude-Bernard, Paris. thomas.aparicio@bch.ap-hop-paris.fr
Bonnaud
G
G
Lucet
J C
JC
Vuagnat
A
A
Leroy
C
C
Bouchaud
O
O
Aumaitre
H
H
Branger
M
M
Fichelle
A
A
Mignon
M
M
Cremieux
A C
AC
D000328:Adult; D000554:Ambulatory Care Facilities; D001803:Blood Transfusion; D015658:HIV Infections / Q000175:diagnosis*; D006526:Hepatitis C / Q000175:diagnosis*; D018937:Hepatitis C Antibodies / Q000097:blood; D006801:Humans; D012307:Risk Factors; D015819:Substance Abuse, Intravenous
D018937:Hepatitis C Antibodies
Evaluation de trois stratégies de dépistage de l'hépatite C en consultation hospitalière de Médecine générale et dans un Centre de dépistage anonyme et gratuit du virus de l'immunodéficience humaine.