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Clinical sciences poster session 5: other
P3-S5.07 Multidisciplinary clinic for the treatment of Hepatitis C: an useful tool for the management of the patients; review of the experience of a regional hospital
  1. P Dolcé1,
  2. S Brin-Clément2,
  3. H Bernatchez1,
  4. P Jutras1,
  5. F Tourangeau1
  1. 1CSSS Rimouski-Neigette, Rimouski, Canada
  2. 2Université du Québec à Rimouski, Rimouski, Canada

Abstract

Background CSSSRN is a regional hospital with 240 acute-care beds, with a multidisciplinary clinic for the treatment of hepatitis C. This study aimed to review the clinical data from treated cases of hepatitis C, including the evaluation of the multidisciplinary support needed.

Methods All files from patients evaluated for hepatitis C at CSSSRN between January 2000 and March 2009 were reviewed for clinical and microbiological data. Also, the numbers of visits to the different clinics were recorded. The data were analysed with Epi Info 3.5.1.

Results A total of 165 cases of hepatitis C were evaluated at our facility and 46 treatments were initiated in 42 patients (four patients had two treatments). The average age was 41 years old (range 22–58) and 78% were men. All, except one, were native from the province of Quebec. The acquisition of hepatitis C was: injection or inhalation drug use (74%), blood transfusion (19%) and other causes (7%). The majority of treated individuals were heterosexual (93%), 55% had a history of alcohol abuse, 30% have been in detention, 19% had attempted suicide and 5% had done prostitution. HIV coinfection was present in three patients and none had HBV coinfection. The genotypes observed were 1 (55%), 3 (29%), 2 (9%) and 4 (7%). Liver biopsy was performed in 26 patients, eight had cirrhosis and one developed liver carcinoma. The treatments received were standard interferon alfa-2b/ribavirine (seven cases, 2000–2002), peginterferon alfa-2b/ribavirine (22 cases, 2003–2006), and peginterferon alfa-2a/ribavirine (17 cases, 2005–2008). Treatment was completed in 78% of patients. Sustained virological response (SVR) was achieved in 53% of genotypes 1 and 4; and in 69% of genotypes 2 and 3. During treatment, an average of 30 visits per patient was recorded. The frequency and mean number of visits were: clinical nurses from the ambulatory care unit (100%, 14), infectious diseases (100%, 10), gastroenterology (100%, 5), psychiatry (35%) and dietetic (16%).

Conclusion A SVR was achieved in 53% (genotypes 1 and 4) and 69% (genotypes 2 and 3) of patients. The treatment of hepatitis C involved an average of 30 visits, with many actors, which is eased by a multidisciplinary clinic.

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