Care of hepatitis C virus infection in France: modifications in three consecutive surveys between 1995 and 2010

Liver International

Accepted Article (Accepted, unedited articles published online and citable. The final edited and typeset version of record will appear in future.)

Original Article

Guillaume Geri¹, Marianne Maynard², Eric Rosenthal³, Hélène Fontaine⁴, Karine Lacombe⁵, Laurence Slama⁶, Cécile Goujard⁷, Véronique Loustaud-Ratti⁸,  Jean-François Bergmann⁹, Philippe Morlat¹⁰, Daniel Vittecoq¹¹, Laurent Alric¹², Patrice Cacoub^1,*, The GERMIVIC Group

DOI: 10.1111/liv.12388

This article is protected by copyright. All rights reserved.

Publication History
Accepted manuscript online: 15 NOV 2013 12:37AM EST
Manuscript Accepted: 9 NOV 2013
Manuscript Revised: 7 NOV 2013
Manuscript Received: 21 SEP 2012

Keywords: hepatitis C virus;  human immunodeficiency virus;  epidemiology;  treatment;  interferon

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.

Patients and methods

Observational multicenter study conducted in 2010 in french internal medicine, infectious diseases and hepatology departments.

Results

1,621 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 the study. Positive viremia was found in 1,025 patients (65.5%) at inclusion in the study. A complete pre-treatment 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 pre-treatment 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).

Conclusion

The care of HCV infected patients has changed significantly in “real life” through an improvement of pre-treatment evaluation before antiviral introduction and the increased use of antivirals. New HCV therapy combinations including protease inhibitors are warranted to increase the SVR rate.

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