[The Hepatitis Network in Maine-et-Loire city hospitals: six year follow-up of patients and physicians. Hepatitis Network of Maine-et-Loire].

OBJECTIVES To evaluate 6 years of a city-hospital hepatitis network. The network was set up in 3 steps: 1988: intrahospital network, 1991: city-hospital network, 1997: compliance with government regulations. METHODS The whole activity from 1991 to 1997 was evaluated and special attention was paid to patient files and participating physicians. RESULTS From June 1991 to December 1997 (6.5 years), 759 patient files were registered which corresponds to 531 patients (male 57%) with a mean age of 44 +/- 16 years (+/- standard deviation). Four hundred and twenty one patients (79%) had hepatitis C, 95 (18%) hepatitis B and 15 (3%) co-infection; 83% of patients had had a liver biopsy confirming cirrhosis in 21.5%. The annual number of files registered increased continuously. This was more a result of recruiting known patients than new patients, after the network had been in place for several years, mainly with hepatitis B virus (known patients in 1997: hepatitis B virus: 53% vs 33% for hepatitis C virus, P<0.05). Treatment protocols (73%) were more frequent for hepatitis C virus patients than for hepatitis B (73% vs 59%, P<0.01). Therapeutic trial proposals (37%) increased from 21% in 1991 to 59% in 1997, P<0.01. Participation in monthly meetings by academic hepato-gastroenterologists increased slightly while that of regional hospital hepato-gastroenterologists increased markedly and that of private hepato-gastroenterologists remained stable. The annual proportion of files submitted by academic hepato-gastroenterologists decreased in parallel to the increase in submission of patient files by other hepato-gastroenterologists. CONCLUSIONS During 6 years of activity, the network grew with an increase in the annual number of patient files, growing participation in therapeutic trials as well as in monthly meetings by practitioners.