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  1. Management of chronic hepatitis C : clinical audit of biopsy based management algorithm.

    Article - En anglais

    Objective 

    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.

    Design 

    Retrospective audit of all patients with chronic hepatitis C attending outpatient clinics over one year.

    Setting 

    The liver unit at a London teaching hospital.

    Subjects 

    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.

    Conclusion 

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0437702

    Code Inist : 002B05C02F. Création : 19/12/1997.