title: Care of hepatitis C virus infection in France: modifications in three consecutive surveys between 1995 and 2010.
abstract: OBJECTIVE
  To determine the characteristics of hepatitis C (HCV)- infected patients in 2010 and compare this survey with those reported in 1995 and 2001.
  
  
  METHODS
  Observational multicentre study conducted in 2010 in French internal medicine, infectious diseases and hepatology departments.
  
  
  RESULTS
  A total of 1621 HCV infected patients (mean age 50.1 ± 10.7 years; sex ratio M/F 1.8; genotype 1: 55.7%) were included. Of these, 910 (56.1%) were HIV–HCV co-infected, 463 (40.4%) were asymptomatic and 184 (16.1%) had cirrhosis at inclusion in this study. Positive viraemia was found in 1,025 patients (65.5%) at inclusion in this study. A complete pretreatment evaluation including investigation for HCV RNA, genotype determination and liver fibrosis was performed in 96.5, 80.5 and 68.7% of the 1,621 patients respectively. Previous and ongoing HCV treatments were noted in 49.6% and 20.1% of patients respectively. A sustained virological response (SVR) was observed in 271/801 (38.3%) patients, i.e. 44.1% and 30.7% in co-infected and mono-infected patients respectively. Cirrhosis was more frequent in the 2010 than in the 2001 and 1995 surveys (16.1% vs. 10.4% and 7.4% respectively; P < 0.0001). A complete pretreatment evaluation was performed in 57.9% and 50.9% of patients in 2010 and 2001 (P < 0.0001). Liver fibrosis evaluation was more frequent in 2010 than in the 2001 and 1995 surveys (68.7% vs. 62.7% and 28.7%, respectively, P < 0.0001).
  
  
  CONCLUSIONS
  The care of HCV-infected patients has changed significantly in ‘real life’ through an improvement of pretreatment evaluation before the antiviral introduction and the increased use of antivirals. New HCV therapy combinations including protease inhibitors are warranted to increase the SVR rate.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Geri
authors.forename: Marianne
authors.initials: M
authors.lastname: Maynard
authors.forename: Eric
authors.initials: E
authors.lastname: Rosenthal
authors.forename: Hélène
authors.initials: H
authors.lastname: Fontaine
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.forename: Laurence
authors.initials: L
authors.lastname: Slama
authors.forename: Cécile
authors.initials: C
authors.lastname: Goujard
authors.forename: Véronique
authors.initials: V
authors.lastname: Loustaud-Ratti
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bergmann
authors.forename: Philippe
authors.initials: P
authors.lastname: Morlat
authors.forename: Daniel
authors.initials: D
authors.lastname: Vittecoq
authors.forename: Laurent
authors.initials: L
authors.lastname: Alric
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D060085:Coinfection / Q000453:epidemiology* / Q000821:virology; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric
chemical_list: D000998:Antiviral Agents