Dr. Andre Jean Remy
Perpignan Hospital, France
Title: New Tools Of Screening Viral Hepatitis In Real Life: The French Model Of Care
Biography
Biography: Dr. Andre Jean Remy
Abstract
Introduction: Hepatitis B and C screening was usually done by serology in laboratories or medical centers. If serology was positive, viral load was determined and after that patient saw hepatologist. Liver fibrosis was measured after first medical consultation. All steps took 3 months. Methods: So hepatitis mobile team proposed new model of screening high risk patients for hepatitis C or B. Nurse and social worker came together in outreach centers, jailhouses, drug services centers and all structures which care drugs users, homeless and precarious patients. They offer triple screening in same time: 1/ social screening with specific score called EPICES, 2/ POCT for HCV HBV 3/ liver fibrosis screening by FIBROSCAN*. With these results, patient could do his/her biology quickly and see hepatologist in 2 weeks only. Drug injection was main contamination route of hepatitis C virus (HCV) in France and Western Europe since 1990. Results: 711 POCT were done in 12 months: 19 positive for new patients and 69 positive for already known patients who returned to medical care; 7 POCT were positive for HBV (but only for 6 months); 393 FIBROSCAN* were done (medium rate 7.8 KPa, fibrosis level F2), 68% for HCV, 3% for HBV and 29% for alcoholic liver disease. Social screening showed that 91% of our patients were precarious. 134 patients were addressed to on site hepatologist consultations. 45% of patients were treated and only 3% lost sight. Conclusions: Our model of care, based on site screening and follow up, increased number of patients diagnosed, treated and cured.
