Search

BACKGROUND AND AIMS: Hepatitis C is poorly documented in migrants. The published studies mainly concern the screening in this population and are limited to some countries in Europe and North America. This study aimed to evaluate the characteristics and care of chronic hepatitis C in this population compared to the nonmigrant population, in the era of direct-acting antivirals (DAAs). METHOD: We performed a retrospective analysis based on data presented at the multidisciplinary team meetings of our tertiary care center between 2015 and 2019. RESULTS: We included 277 migrant- and 1390 nonmigrant patients mono-infected with hepatitis C virus (HCV) and treated with DAAs. The majority of the migrants were from Eastern European countries. In multivariable analysis, BMI classes associated with more obesity (OR = 1.84; 95% CI, 1.37-2.49; P < 0.001) and therapeutic patient education (OR = 3.91; 95% CI, 2.38-6.49; P < 0.001) were positively associated with migrant status, whereas age (OR = 0.92; 95% CI, 0.90-0.94; P < 0.001), female gender (OR = 0.46; 95% CI, 0.28-0.74; P = 0.002), modes of contamination with less drug use, transfusion history or nosocomial risk, as well more unknown mode (OR = 0.70; 95% CI, 0.50-0.96; P = 0.031), alcohol consumption (OR = 0.48; 95% CI, 0.29-0.73; P = 0.001), types of structures with less care in a general hospital or health network of general practitioners and more care in a university hospital or primary addictology center (OR = 0.78; 95% CI, 0.60-0.99; P = 0.046) and opioid substitution therapy (OR = 0.25; 95% CI, 0.08-0.68; P = 0.008) were negatively associated with migrant status. The substained virologic response 12 was close to 97% in both groups. CONCLUSION: Despite multiple differences in characteristics and therapeutic care between the two populations, the chances of healing hepatitis C were the same among migrant- compared with nonmigrant patients.

People who use drugs (PWUDs) are the main group at risk for hepatitis C virus (HCV) transmission and a key population for hepatitis C elimination. Multidisciplinary team (MDT) meetings were set up in France in December 2014 within regional reference centers to supervise the prescriptions and delivery of direct-acting antivirals (DAAs) to optimize the management of HCV infection. The aim of this retrospective study was to analyze the changes in the profile and therapeutic care of PWUDs with HCV mono-infection according to the evolution of MDT meetings in a regional tertiary reference center.Between 2015 and 2019, overall 1912 HCV-infected patients presented at the MDT meetings, 547 were PWUDs with HCV mono-infection treated with DAAs. Five periods were defined according to the evolution of MDT meetings. The profile and management of PWUDs were compared among these five periods.Over time, the frequency of advanced stage of fibrosis decreased from 90.8 to 36.3% (P 0.001), whereas the therapeutic care of the patients in primary addictology centers and networks of general practitioners increased from 17.4 to 55% (P 0.001). The frequency of excessive alcohol consumption varied between 9.1 and 30% (P = 0.003) and that of opioid substitution therapy between 42.5 and 70% (P 0.001). The Sustained virologic response assessed 12 weeks after the end of treatment rate was above 95% for the five periods.Between 2015 and 2019, the changes in the profile and management of PWUDs have followed the evolution of MDT meetings concerning patients with less advanced fibrosis and more therapeutic hepatitis C care made by the primary care centers.

HCV can cause psychiatric disorders. It is crucial to re-evaluate them with direct-acting antiviral treatment (DDAs), since the interferon-based treatments of the past were capable of causing identical psychiatric adverse effects. A system of multidisciplinary team (MDT) meetings was implemented in France in December 2014 in regional reference centers with the aim of controlling the prescription and administration of these new treatments, along with optimizing how the patients undergoing these treatments are followed up. Our study sought to compare the characteristics and type of medical care received for chronic hepatitis C in patients with (PSY+ group) and without (PSY- group) psychiatric disorders using data from MDT meetings in the Alsace area of France collected from 2015 to 2019. All included patients were mono-infected and treated with DAAs in successive rounds between 2015 and 2019, as per recommendations from the French Hepatology Society. We compared the two groups (PSY+ and PSY-) based on 21 variables regarding the characteristics and medical care of hepatitis C. Psychiatric disorders were observed in 15% of patients. On multivariate analysis, a positive correlation was found between them and drug use (OR: 2.35; 95%CI: 1.40-3.98; p=0.001), excessive alcohol consumption (OR: 1.92; 95%CI: 0.98-3.69; p=0.05), smoking (OR: 1.81; 95%CI: 1.09-2.98; p=0.02), and incidence of drug interactions (OR: 3.94; 95%CI: 2.15-7.17; p

Aim: Chronic hepatitis C is more severe in elderly patients. In France, Direct Acting Antiviral therapy must be implemented via multidisciplinary team meetings in regional reference centers. This study aimed to define the impact of age on hepatitis C characteristics and medical care types across three groups: 70-yo. Methods: All patients with treated hepatitis C virus mono-infection during 8 to 24 weeks were included. Group comparison was based on 21 hepatitis C characteristic and medical care variables. Results: Male predominance decreased in >50-yo (59.7% vs. 72.5%, p 70-yo (36.2%, p 50-yo (27.8% vs. 51.9%, p=0.02) and increase in transfusion and nosocomial infection to 30% in >70-yo. Advanced fibrosis increased in >50-yo (57.5% vs. 41.5%, p 70-yo affected. Psychiatric comorbidity incidence was halved in >70-yo (7.1% vs. 14.8%, p 70-yo vs. 43.8% for 70-yo. Substained virological response 12 rates did not significantly differ across the three groups. Conclusions: Age changes the characteristics and the medical care of hepatitis C, but has no impact on the cure rate.