Decline in HCV testing and compliance with guidelines in patients of Sentinelles general practitioners, 1996-2002.
Between 1996 and 2002, the French Sentinelles Network observed a more than 2-fold decline in the annual rate of hepatitis C virus (HCV) screening tests prescribed by general practitioners. During this period it droped from 1080 to 450 per 100,000 inhabitants. The proportion of HCV-positives increased from 9.7% to 12.9% between 1996 and 1998 but declined steadily afterwards, reaching 7% in 2002. The majority of HCV-positive patients were men (57%), 38% were aged 30-39 years and 45% were injecting drug users. Two French guidelines for HCV screening were issued in 1997 and 2001. Of the 3462 patients with a known HCV test result, 27.4% were offered following the 1997 guidelines, among which 23.7% were HCV-positive. Of the same 3462 patients, 36.8% were offered following the extended definition of the risk group in the 2001 guidelines, among which 19.9% were positive. The percentage of subjects tested with no biological sign or clinical symptom and no HCV risk factor varies from 11% to 26% showing that SGPs carry out a targeted screening even if they deviate from the strict recommendations. Of the HCV-positive patients, 14% did not meet any criteria of the guidelines suggesting a lack of sensitivity in the current definition of patients recommended for testing.
Massari
Véronique
V
Universite P & M Curie, INSERM, Paris, 75012, France. massari@u707.jussieu.fr
Viboud
Cécile
C
Dorléans
Yves
Y
Flahault
Antoine
A
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D005260:Female; D005602:France / Q000453:epidemiology; D006526:Hepatitis C / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010821:Physicians, Family; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013997:Time Factors