{"id":1763,"date":"2003-10-01T01:00:00","date_gmt":"2003-10-01T00:00:00","guid":{"rendered":"https:\/\/angh.net\/abstracts\/hepatite-c-et-prison-le-depistage-et-le-traitement-sameliorent-resultats-comparatifs-de-2-enquetes-nationales-de-pratiques-2000-2003\/"},"modified":"2018-10-20T18:39:30","modified_gmt":"2018-10-20T16:39:30","slug":"hepatite-c-et-prison-le-depistage-et-le-traitement-sameliorent-resultats-comparatifs-de-2-enquetes-nationales-de-pratiques-2000-2003","status":"publish","type":"post","link":"https:\/\/angh.net\/abstracts\/hepatite-c-et-prison-le-depistage-et-le-traitement-sameliorent-resultats-comparatifs-de-2-enquetes-nationales-de-pratiques-2000-2003\/","title":{"rendered":"HEPATITE C ET PRISON: LE DEPISTAGE ET LE TRAITEMENT S\u2019AMELIORENT : RESULTATS COMPARATIFS DE 2 ENQUETES NATIONALES DE PRATIQUES 2000-2003."},"content":{"rendered":"

2003<\/strong><\/p>\n

AJ Remy(1,2), F Khemissa (1), M Beaubois (2), S Ollivier (1), B H\u00e9ran (1).
\n(1) Service d\u2019H\u00e9pato-Gastroent\u00e9rologie, R\u00e9seau H\u00e9patite C de Catalogne et du pays d\u2019Oc, (2) Unit\u00e9 de Consultations et de Soins Ambulatoires (UCSA)
\nCentre Hospitalier Saint-Jean, Perpignan<\/em><\/p>\n

H\u00e9patologie <\/strong>– \u00a02000-03-09 –\u00a0CO –<\/p>\n

________________________________<\/p>\n

L\u2019h\u00e9patite C est devenu un probl\u00e8me important en milieu carc\u00e9ral, soulign\u00e9 par les conf\u00e9rences de consensus. Une premi\u00e8re enqu\u00eate nationale de pratiques, r\u00e9alis\u00e9e par notre \u00e9quipe en 2000 avait mis en \u00e9vidence un d\u00e9pistage effectif dans 2\/3 des \u00e9tablissements p\u00e9nitentiaires, la r\u00e9alisation de biopsies h\u00e9patiques chez un tiers des patients d\u00e9pist\u00e9s ou d\u00e9j\u00e0 connus ; cependant la mis en place d\u2019un traitement antiviral ne concernait que moins de 4% des personnes atteintes. Objectifs : Evaluer l\u2019\u00e9volution de la prise en charge diagnostique et th\u00e9rapeutique de l\u2019h\u00e9patite chronique virale C dans les centres p\u00e9nitentiaires (CP) fran\u00e7ais entre 2000 et 2003. M\u00e9thodologie : enqu\u00eate postale sur les 172 UCSA fran\u00e7aises avec la m\u00eame fiche d\u2019enqu\u00eate que pour l\u2019\u00e9tude de 2000.Les r\u00e9sultats de l\u2019enqu\u00eate 2003 sont pr\u00e9sent\u00e9s de fa\u00e7on comparative avec les donn\u00e9es obtenues en 2000 (entre parenth\u00e8ses, avec une * quand la comparaison atteint la significativit\u00e9, p < 0,01). R\u00e9sultats : 85 CP (49%) ont r\u00e9pondu au questionnaire en 2000 comme en 2003. La prise en charge de l\u2019h\u00e9patite C est effective dans 97% des CP (97%). Le nombre de d\u00e9tenus \u00e9tait de 28535 (27245) avec une moyenne par CP de 391 (320), soit la moiti\u00e9 des d\u00e9tenus en France. La s\u00e9rologie C est syst\u00e9matique \u00e0 l\u2019entr\u00e9e dans 28% (35%*) des CP, syst\u00e9matiquement propos\u00e9e dans 64% (36%*). Le total des s\u00e9rologies C positives par mois \u00e9tait de 179 pour 58 \u00e9tablissements soit 3,1 (4,1) en moyenne\/CP\/mois (extr\u00eames 0-58). Le nombre de sujets connus VHC positif \u00e9tait de 2107 (1645) sur 62 CP, soit 24,9 (22,8) par \u00e9tablissement (extr\u00eames 0-272) et une pr\u00e9valence moyenne de 7,3% (6,7%) (extr\u00eames 0-17%). Il existe un consultation d\u2019h\u00e9patologie \u00ab intramuros \u00bb dans 40% des CP (42%), et une consultation de maladies infectieuses dans 17% (18%). <\/p>\n

Le nombre de biopsies h\u00e9patiques (PBH) r\u00e9alis\u00e9es par an se r\u00e9partissait de la fa\u00e7on suivante : 0 PBH, 49 (33*) CP ; moins de 12\/an, 30 (30) CP ; plus de 12 \/ an, 6 (22*) CP (extr\u00eames 1-10\/mois). Au total 529 PBH ont \u00e9t\u00e9 r\u00e9alis\u00e9es en 2002 (545), soit 8 (6) PBH\/CP\/an; soit un rapport PBH sur malades connus VHC positifs de 25% (33%). Le d\u00e9lai moyen d\u2019attente de la PBH est de 29 jours (35 jours) (extr\u00eames 3 jours \u2013 4 mois). La PBH est r\u00e9alis\u00e9e en h\u00f4pital de jour dans 55% (52%) des CP. Deux cent soixante dix-huit (164*) malades ont \u00e9t\u00e9 trait\u00e9s en 2002 ; mais dans 29 % (44%*) des CP, aucun malade n\u2019est trait\u00e9. La bith\u00e9rapie interf\u00e9ron p\u00e9gyl\u00e9 et ribavirine \u00e9tait tr\u00e8s largement utilis\u00e9e pour 81% des malades. Le traitement \u00e9tait initi\u00e9 en prison dans 81% des cas (77%). Le suivi th\u00e9rapeutique se faisait dans 80 % des cas en prison (67%), plus souvent par le m\u00e9decin sp\u00e9cialiste que par le m\u00e9decin g\u00e9n\u00e9raliste. Au total, 13,2% des personnes atteintes ont \u00e9t\u00e9 trait\u00e9es en 2002, contre<\/p>\n

Conclusions : Ce travail constitue la deuxi\u00e8me enqu\u00eate nationale de pratiques sur la prise en charge diagnostique et th\u00e9rapeutique de l\u2019h\u00e9patite C en prison en France ; elle permet d\u2019\u00e9valuer l\u2019\u00e9volution de cette prise en charge au quotidien dans les UCSA.. Le nombre d\u2019UCSA participantes et de d\u00e9tenus concern\u00e9s garantissent la repr\u00e9sentativit\u00e9 de notre enqu\u00eate, tant en 2000 qu\u2019en 2003. Ceci montre \u00e9galement l\u2019engagement persistant des m\u00e9decins des UCSA dans la prise en charge des personnes atteintes d\u2019h\u00e9patite C. La pr\u00e9valence de l\u2019h\u00e9patite C est stable en France en milieu carc\u00e9ral. Le d\u00e9pistage de l\u2019h\u00e9patite C, syst\u00e9matique ou syst\u00e9matiquement propos\u00e9, est g\u00e9n\u00e9ralis\u00e9. Toutefois, les consultations sp\u00e9cialis\u00e9es intra-muros restent insuffisantes. Le nombre de PBH r\u00e9alis\u00e9es est stable mais toujours faible. Cette non augmentation, alors que le nombre de personnes trait\u00e9es augmente, pourrait \u00eatre la cons\u00e9quence de l\u2019application des recommandations de la conf\u00e9rence de consensus 2002, limitant le recours \u00e0 la PBH dans certaines situations, et qui semble particuli\u00e8rement adapt\u00e9e aux contraintes de la conf\u00e9rence de consensus.<\/p>\n","protected":false},"excerpt":{"rendered":"

2003 AJ Remy(1,2), F Khemissa (1), M Beaubois (2), S Ollivier (1), B H\u00e9ran (1). (1) Service d\u2019H\u00e9pato-Gastroent\u00e9rologie, R\u00e9seau H\u00e9patite C de Catalogne et du pays d\u2019Oc, (2) Unit\u00e9 de Consultations et de Soins Ambulatoires (UCSA) Centre Hospitalier Saint-Jean, Perpignan H\u00e9patologie – \u00a02000-03-09 –\u00a0CO – ________________________________ L\u2019h\u00e9patite C est devenu un probl\u00e8me important en milieu […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[3],"tags":[14],"class_list":["post-1763","post","type-post","status-publish","format-standard","hentry","category-hepatologie","tag-14"],"yoast_head":"\nHEPATITE C ET PRISON: LE DEPISTAGE ET LE TRAITEMENT S\u2019AMELIORENT : RESULTATS COMPARATIFS DE 2 ENQUETES NATIONALES DE PRATIQUES 2000-2003. - 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