[Hepatitis C epidemiology at a general hospital center. Management and natural history as a function of the manner of identification].
OBJECTIVE
To study the epidemiological characteristics of patients with chronic hepatitis C virus followed in a primary referral hospital and the clinical influence of "systematic screening" defined as the screening of patients without symptoms and with known risk factors of hepatitis C (past transfusion, past or present intravenous drug use, haemodialysis) on the natural history and treatment of chronic hepatitis C virus.


METHODS
The files of 311 consecutive patients who screened positive for anti-hepatitis C virus and were seen at the primary referral hospital, Creil, from January 1992 to February 1996, were analyzed.


RESULTS
Patients who underwent "systematic screening" were younger with a shorter duration of infection. They were more often intravenous drug addicts and had lower alanine aminotransferase activity and Knodell scores than patients who underwent screening during "a diagnostic procedure", because of symptoms and/or abnormal liver biochemistry. Increased age at contamination and alcohol consumption of more than 40 g per day was associated with an increased risk of cirrhosis while patients who underwent "systematic screening" had a lower risk of cirrhosis and higher survival rate. Interferon therapy was attempted less often in anti-hepatitis C virus positive patients from "systematic screening" programs.


CONCLUSIONS
Anti-hepatitis C virus positive patients from "systematic screening" programs had a benign disease and were rarely treated with interferon compared to anti-hepatitis C virus positive patients diagnosed during a "diagnostic procedure".
Cadranel
J F
JF
Unité d'Hépatologie, Service de Médecine Générale et Digestive, Centre Hospitalier Laennec, BP 72, 60109 Creil.
Di Martino
V
V
Cesbron
H
H
Cazier
A
A
Demontis
R
R
Coutarel
P
P
Bachmeyer
C
C
Cordier
F
F
Lukumbo
S
S
Fiévet
P
P
Mougeot-Martin
M
M
Van Batten
C
C
Devergie
B
B
Dumouchel
P
P
D005260:Female; D005602:France; D006526:Hepatitis C / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies