Hepatitis C in 600,000 contaminated French, only 15,000 are treated

About 600,000 infected in France, 15,000 only treated her, so people with hepatitis C is responsible for 4,000 deaths annually (4 times more than AIDS) and 5,000 new infections per year, said Dr. Thierry Poynard (Pitié -Salpêtrière, Paris), during a press conference at Medec annual exhibition of medicine that took place in Paris.

"Only half of the people infected with hepatitis C is detected, less than 10% are treated, while today's doctors have a treatment that turns curator in 50% of cases," says Professor Poynard.

However, the number of liver cancer associated with hepatitis C is increasing, responsible for deaths gastrointestinal bleeding (one third of cases) or hepatic impairment (also third). The goal is to detect and treat 80% of patients, hope the specialist.

It is important, he said, to simplify the assessment of hepatitis C and treat the card individually according to weight, age, degree of fibrosis and steatosis.

"The treatment of hepatitis C is an emergency in more than 65 years, because it is they who have the greatest risk of dying from the disease when it passes into the stage of chronicity," informs the gastroenterologist.

SAVE TIME

For Dr. Lawrence Cattan, a general practitioner in Paris, saving time is essential in this type of testing.

"Not only is it important to talk to test the existence of a patient, a tattoo or piercing (even if the reason for consultation is different), but it seems important to know the best diagnostic approach before referring to a specialist:. whether the serological test for hepatitis C is positive with elevated transaminases, quantitative PCR is then necessary to define viremia in non-viremic, the speech should be reassuring. Simple monitoring is needed renewing PCR six months later, "said the doctor.

Moreover, the arrival of biochemical markers has revolutionized the care of a patient with chronic hepatitis C.. With a simple blood test, these markers made using a test (Fibrotest-Actitest available in France since September 2002 and more than 500 private medical analysis laboratories) to assess the condition of the liver and assist in the therapeutic decision.

"Unlike liver biopsy, this test is non-invasive, simple to perform and gives only 2% false positive or negative, versus 18% for biopsy (9 times more), at a cost that rises 90 euros (versus € 1,000 for biopsy), "reveals Professor Poynard.

TREATMENT MUST BE THE MOST POSSIBLE EARLY

If an anti-viral treatment is necessary, the GP can renew and manage adverse events: this aspect alone represents "the key to successful treatment," said Dr. Cattan. Indeed, 10% of patients stop taking their medication because of severe side effects, says Professor Poynard.

However, according to him, the dose as well as the duration (6 months minimum) are important to consider. "Generally, he says, it starts the anti-viral treatment at full dose, then consider lowering the dosage in case of major intolerance. Can also be considered a therapeutic window," he says.

Counseling is now routinely offered to the patient, because of the risk of depressive syndrome and mood disorders that can induce anti-viral.

But healing is often at the end of the tunnel as reported through the sick. "It can be confirmed when viremia remained negative after 6 months of treatment stop", informs the specialist. / Ajr