title: Diagnosis and 10-year follow-up of a community-based hepatitis C cohort.
abstract: OBJECTIVE
  To determine the health care follow-up and treatment associated with physician-diagnosed hepatitis C (HCV) in a community-based population.
  
  
  METHODS
  We conducted a retrospective medical record review using records from all providers in Olmsted County, Minnesota.
  
  
  METHODS
  The study incorporated all Olmsted County residents with physician-diagnosed hepatitis C from 1990 through 1999.
  
  
  METHODS
  We assessed demographic and health status information as well as health services use in subjects with physician-diagnosed HCV.
  
  
  RESULTS
  Physicians diagnosed hepatitis C in 355 subjects (219 men [62%], 136 women [38%]), mean age 43 years, in the 10-year period studied. About half of diagnoses (45%, n = 159) were confirmed with polymerase chain reaction or liver biopsies. Identified risk factors included IV drug use (50%), multiple sex partners (36%), and blood transfusion (30%). Follow-up assessment with aspartate aminotransferase/amino alanine transferase (AST/ALT) tests occurred in about half (49%) of subjects, while 202 subjects (60%) were referred for gastrointestinal (GI) specialist evaluation and 49 patients (14% of all, 25% of those referred to a GI specialist) had specific treatment for hepatitis C. Although well over half of patients (60%) had possible contraindications to HCV treatment, including heavy alcohol use, few were referred for chemical dependency therapy.
  
  
  CONCLUSIONS
  In this community, follow-up and treatment related to HCV were limited. Attention to prevention of disease-accelerating co- infections was only modest. Referral or documented recommendations for treatment of alcoholism or heavy chronic alcohol ingestion were minimal.
authors.affiliation: Department of Clinical Research, Olmsted Medical Center, 210 Ninth St., SE, Rochester, MN 55904, USA. yawnx002@gold.tc.umn.edu
authors.forename: Barbara P
authors.initials: BP
authors.lastname: Yawn
authors.forename: Peter
authors.initials: P
authors.lastname: Wollan
authors.forename: Liliana
authors.initials: L
authors.lastname: Gazzuola
authors.forename: W Ray
authors.initials: WR
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000592:standards* / Q000706:statistics & numerical data; D015897:Comorbidity; D003266:Continuity of Patient Care; D005260:Female; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D011320:Primary Health Care; D011787:Quality of Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors