Screening for hepatitis C.

The development of a screening program for hepatitis C is justified by the following reasons: hepatitis C virus infection is a public health problem because of its frequency and its possible serious complications; accurate, affordable and acceptable tests for the detection of pre-clinical disease are available; additional effective antiviral treatment regimens are also available; and there is a preventive benefit through reducing high-risk practices. Screening for hepatitis C should be part of a comprehensive strategy of prevention and clinical management of the infection and related complications. Despite the specific organization of health care services for hepatitis C ('regional reference centers' and health care networks), the proportion of infected patients covered by clinical management programs remains insufficient. It is therefore necessary to improve current knowledge for the reasons for the non-attendance of patients with hepatitis C from the point of view of patients as well as physicians. This would allow the identification of possible barriers to care, and also possible strategies to overcome these barriers with the aim of increasing the coverage of care and the follow-up of patients infected with hepatitis C. (C) 1999 Elsevier, Paris.