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FibroScan used among drug users is useful for hepatitis C virus screening

 

Interview of Dr Juliette Foucher, Hepatogastroenterology Department, Haut-Levêque Hospital (France)

 

 

Could you briefly tell us about the main objectives of your study?

Why did you choose to focus on these objectives?

 

The purpose of this study was to perform a FibroScan® on a population of drug users, to find out whether FibroScan® could help in the screening and treatment of Hepatitis C in that population. 

Why did we want to do that? Hepatitis C is very common in drug users. Those people do not often get tested, and even when they know they are positive, it is difficult for them to get into a treatment programme.

The aim was to see whether performing a FibroScan® could change the situation, and make it easier for them to undergo screening and enter a treatment program.

 

 

Could you present the inclusion criteria and also the targeted population? Why did you choose these criteria?

 

We tried to reach the widest possible population of users visiting this treatment centre for addicts in Bordeaux.

A FibroScan® exam was therefore offered to all users who came to the centre.  Some were still actively addicted, some had a treatment or no substitution, and some might have knowingly been carrying a form of viral hepatitis.

We offered them a FibroScan® exam and then, after the FibroScan®, we offered to perform blood tests to check for viral hepatitis. If the test was positive for hepatitis C, we then invited them to meet a hepatologist within the same treatment centre. 

 

Could you briefly outline the results?

 

The study was carried out between January 2006 and January 2007. About 300 users were included in the study. All of them accepted the FibroScan® exam.  Following the FibroScan®, they were offered a blood test. 97% of them agreed to the idea of this blood test.

We are dealing with drug users, however; and finally just three quarters of them actually had the blood tests.

The fibrosis results showed minimal fibrosis in about 80% of the users, but in 8% of cases, a FibroScan® level above 9.5 kPa was detected: a sign of severe fibrosis or even cirrhosis. 

With regard to the hepatitis C results: 83 serologies came back positive; most from users who knew they were carrying the virus, but 17 of the positive serologies were not expected, and 11 of those were in patients who thought they were negative with regard to the hepatitis C virus.

Finally, in the first year, eight courses of treatment were initiated.

 

Which key points of the study are to be remembered? In conclusion, what improvements will your study bring to clinical practice and patients?

 

The first key point is the very high acceptance of FibroScan® in a population of drug users, who are not necessarily easy to treat.

The second interesting point is that 75% of these users who had a FibroScan® exam then had a blood test for hepatitis C. The results of this study were especially encouraging, and we have therefore undertaken a larger multicentric study, which is currently underway in 12 centres in France, to try to show that the presence of a FibroScan® unit in an addiction treatment centre can improve the screening and treatment of viral hepatitis in drug users.

 

 

 

 

 

27.03.2018