Half a million French are infected with hepatitis C virus

BMJ 1995; 311 doi: (Published 04 November 1995) Cite this as: BMJ 1995;311:1187
  1. ALEXANDER DOROZYNSKI, freelance journalist
  1. Paris

    At least 500000 people in France have been infected with hepatitis C virus, according to a report released last week by the minister of health, Dr Elisabeth Hubert. This is the first time that detailed statistics have been made available to evaluate the number of infections, which were previously estimated at 500000 to two million. The report is the outcome of seven epidemiological surveys carried out over the past two years by teams of experts including virologists and specialists in public health. It was prepared by the national public health network, directed by Professor Jacques Drucker.

    The survey found that 1.2% of adults aged 20 to 59 have antibodies to hepatitis C virus and that the virus is present in 80% of people who are seropositive. At least 60% of the infections were transmitted by blood transfusions or by drug misusers using infected needles. The prevalence of infection among health staff is not known but may be as high as 3%.

    The surveys included a study among 20000 pregnant women and another among 6000 volunteers from the rolls of people insured under the social security system. Results agreed with statistics gathered during routine screening of blood donors. Additional studies will be carried out to look at the prevalence of infection among children and young people under 20 and in people over 60. A survey among 6300 people who attended for health checks showed that one third of those who were seropositive had received a blood transfusion and that one third of those infected were not aware of their seropositivity. It is estimated that 600 new cases will be diagnosed each year and that 3500 to 5000 patients should benefit from treatment with interferon.

    The report found that many doctors were reluctant to use this treatment, although studies have shown that the earlier it is started the more effective it is. Two types of genetically engineered interferon alfa are used, one produced by Roche Laboratories and another by Schering-Plough. A year's treatment may cost about Fr20000 (pounds sterling2600), but discussions are under way to reduce the price.

    Dr Hubert says that she will write to all general practitioners urging them to screen for the virus, paying particular attention to people who have received blood transfusions, patients with liver problems, and drug misusers. Another letter will urge surgeons, dentists, and other health staff using invasive techniques to pay more attention to the risks of infection.

    Now that reliable data are available the government is turning to the problem of compensation. This was raised more than two years ago by patients' associations, which asked for compensation for patients with active chronic hepatitis who had received blood transfusions before screening of donors for the virus became compulsory in March 1990. The associations have suggested that compensation should average about Fr500000 (pounds sterling65000). If it turns out that a third of all infections can be proved to have been caused by blood transfusions compensation may total billions of francs.

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