How many of you are treating Hepatitis C?

[a768678]

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Just curious.

Do you try to handle it yourself or do you automatically refer out?
Are you doing screening at your practice on the folks with increased risk of the disease?
How much of it are you seeing, is your practice rural or big city, etc?

 

[Doctor4Life1769]

I screen. If positive, I get the quant and the genotype, then refer to GI for treatment and continued monitoring.

 

[VA Hopeful Dr]

Just started treatment yesterday on my first - no insurance, can't afford GI/ID referral.

 

[deleted87716]

Screen and refer. Like HIV, I see it so infrequently in my practice that it's just not worth "winging it."

For those who can't afford appropriate treatment (let's face it, if they can't afford treatment with GI or ID, they probably aren't going to be able to afford it with me, either), I can usually find somebody at a referral center who will treat them for free.

 

[VA Hopeful Dr]

Screen and refer. Like HIV, I see it so infrequently in my practice that it's just not worth "winging it."

For those who can't afford appropriate treatment (let's face it, if they can't afford treatment with GI or ID, they probably aren't going to be able to afford it with me, either), I can usually find somebody at a referral center who will treat them for free.

Its infuriating, the local tertiary center here only takes unfunded patients from one of the two counties that the city straddles.

 

[FrustratedFamDoc]

Screen and refer. I see it a good bit. Both GI groups in town readily accept all insurance types.

 

[Doctor4Life1769]

Its infuriating, the local tertiary center here only takes unfunded patients from one of the two counties that the city straddles.

How are you able to have your patient afford the cost of the medication?

 

[Doctor4Life1769]

Screen and refer. I see it a good bit. Both GI groups in town readily accept all insurance types.

I've been seeing it more lately.

 

[VA Hopeful Dr]

How are you able to have your patient afford the cost of the medication?

Patient assistance program

 

[Bacchus]

Refer. We have a leading hepatologist in our area.

 

[smq123]

I've been seeing it more lately.

It was always there; I think that, as some of the Hep C programs in the area are closing down, they're being sent out into the community.

 

[styphon]

I screen. If positive, I get the quant and the genotype, then refer to GI for treatment and continued monitoring.

I do the same, if anything hepatitis C is on the rise here from rampant heroin use.

 

[Doctor4Life1769]

It was always there; I think that, as some of the Hep C programs in the area are closing down, they're being sent out into the community.

True.

I meant the newly diagnosed ones. I've had several tell me they weren't positive before (turns out the prior PCPs never screened) and with further questioning prior to screening there was at least 1 risk factor.

 

[smq123]

I do the same, if anything hepatitis C is on the rise here from rampant heroin use.

The most memorable method of transmission that I'd heard was from a patient who used to snort crushed opiates. He was sharing a mirror with another user - that user got a big nosebleed, and the patient (gulp) didn't bother to clean the mirror before snorting his turn. He claims that he got Hep C from that - no history of IV drug use or blood transfusions. He could have had sex with someone with Hep C, though.

 

[Doctor4Life1769]

The most memorable method of transmission that I'd heard was from a patient who used to snort crushed opiates. He was sharing a mirror with another user - that user got a big nosebleed, and the patient (gulp) didn't bother to clean the mirror before snorting his turn. He claims that he got Hep C from that - no history of IV drug use or blood transfusions. He could have had sex with someone with Hep C, though.

Patients lie too

 

[letsdoit]

Diagnose and refer.

 

[simpler2]

Its treated more by primary care than ID/Gastro/Hepatology in our region (SouthWest). I saw the same with HIV in the south. If the prevalence exceeds specialist capacity, this seems to be the trend. Unlike HIV treatment, the medications are fewer and treatment is short term for Hepatitis C. Side effects with most current treatments is almost null as well. I would readily encourage anyone in primary care to treat if they have interest.

 

[deleted87716]

FYI, this is a 2-year-old zombie thread, and the OP was banned.

 

[VA Hopeful Dr]

FYI, this is a 2-year-old zombie thread, and the OP was banned.

Yeah, somebody came through and bumped like a dozen old threads

 

[FrustratedFamDoc]

Noticed it too but it's been pretty slow here lately so I obliged.

 

[deleted87716]

Yeah, somebody came through and bumped like a dozen old threads

It was actually more like two dozen, which pushed all of the current conversations halfway down the page. Not cool.