Management of chronic hepatitis C : clinical audit of biopsy based management algorithm.
To assess the attendance, outcome, compliance with treatment, and response to interferon alfa in patients with chronic hepatitis C who attended during 1995 and were treated according to a biopsy based algorithm.
Retrospective audit of all patients with chronic hepatitis C attending outpatient clinics over one year.
The liver unit at a London teaching hospital.
255 patients with chronic hepatitis C. Main outcome measures : Patient survival, attendance, and compliance with diagnostic and therapeutic regimens.
Response to interferon alfa treatment, based on loss of viraemia three months after cessation of treatment Results : A large proportion of patients (39%) with newly diagnosed chronic hepatitis C infection do not want to undergo further investigation.
Of those patients who do attend for further treatment, a large proportion with severe hepatic fibrosis (42%) do not want to undergo currently available treatment The response rate to interferon (21%) in treated patients was similar to that previously reported in a trial setting.
There was no significant difference in response rates in patients with or without severe fibrosis not amounting to cirrhosis.
In patients with cirrhosis there was a high incidence of hepatocellular carcinoma (18%) over a follow up period of 20 months.
Current strategies aimed at investigating and treating patients with chronic hepatitis C are not acceptable to a large proportion of patients. (...)
Mots-clés Pascal : Hépatite virale C, Virose, Infection, Gestion, Audit, Interféron alpha, Evaluation, Efficacité traitement, Analyse algorithme, Biopsie, Article synthèse, Homme, Appareil digestif pathologie, Foie pathologie, Organisation santé, Cytokine
Mots-clés Pascal anglais : Viral hepatitis C, Viral disease, Infection, Management, Audit, Alpha interferon, Evaluation, Treatment efficiency, Algorithm analysis, Biopsy, Review, Human, Digestive diseases, Hepatic disease, Public health organization, Cytokine
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0437702
Code Inist : 002B05C02F. Création : 19/12/1997.