Magnitude and management of HCV infection in France.

The prevalence of hepatitis C virus infection in the general population in France averages 1%. The majority of these patients are viremic with detectable HCV-RNA. Further, 75% of these individuals did not suspect they were at risk for being HCV carriers. Less than 10% of HCV carriers in France have been identified and even fewer have been treated with interferon. In addition to infection following intravenous drug use, preliminary studies suggest that most newly infected patients have become infected following surgery or endoscopy without transfusion. A large serological study of patients scheduled for surgery identified 4% HCV carriers. Other studies have determined that more than 8% of patients who received prior transfusions are now anti-HCV positive. These findings prompted the French government to initiate a screening program in France to identify patients at risk for HCV infection. This national program also involves the establishment of regional HCV reference centers to coordinate efforts among hospitals, gastroenterology/hepatology specialists, and general practitioners. The mission of the program is to promote screening and disseminate appropriate clinical practice guidelines for the management of HCV infection. The goal is to identify infected patients and initiate optimal interferon therapy as early as possible in the course of HCV infection to prevent the long-term complications secondary to infection.