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Semin Liver Dis 2005; 25(1): 65-71
DOI: 10.1055/s-2005-864782
Copyright © 2005 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001 USA.

Treating Chronic Hepatitis C in the Primary Care Setting

Thomas G. McGinn1 , 2 , Donald Gardenier2 , Lata K. McGinn2 , David Alfandre2 , Nicola O'Connor-Moore2 , Toni M. Sturm2 , Thomas D. Schiano2 , Stanley Reichman2
  • 1Chief, Division of General Internal Medicine
  • 2The Mount Sinai School of Medicine, New York, New York
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Publication History

Publication Date:
25 February 2005 (online)

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Abstract

The National Institutes of Health and other institutions have emphasized the need to expand access to treatment of chronic hepatitis C virus infection to a larger and more diverse patient population. To begin to address this need, the divisions of General Internal Medicine and Liver Diseases of the Mount Sinai Medical Center created a program to identify patients who might benefit from hepatitis C treatment, to treat uncomplicated patients in the primary care setting, and to refer appropriate patients to liver disease specialists. Preliminary data from this program suggest that primary care-based treatment of chronic hepatitis C may offer unique advantages. The primary care setting allows special needs to be addressed and allows comprehensive services to be provided. Patients are guided through the complex pretreatment evaluation process, and non-liver-related comorbidities are managed. Our program may provide a useful model for increasing hepatitis C literacy among primary care providers and for extending treatment to a broader population of patients with hepatitis C.

KEYWORDS

Access - comorbidity - hepatitis C - risk factor - treatment - primary care

REFERENCES

  • 1 Liang T J, Rehermann B, Seeff L B, Hoofnagle J H. Pathogenesis, natural history, treatment, and prevention of hepatitis C.  Ann Intern Med. 2000;  132 296-305
    PubMedGoogle Scholar
  • 2 UNAIDS .Global Summary of the AIDS Epidemic. New York; United Nations Publication 2004
    Google Scholar
  • 3 Heller T, Rehermann B. Acute hepatitis C: a multifaceted disease.  Semin Liver Dis. 2005;  25 7-17
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Di Bisceglie A. Hepatitis C.  Lancet. 1998;  31 351-355
    PubMedGoogle Scholar
  • 5 National Institutes of Health Consensus Development Conference Statement .Management of Hepatitis C: 2002. Bethesda, MD; The National Institutes of Health August 27, 2002
    Google Scholar
  • 6 Drusano G, Preston S. A 48-week duration of therapy with pegylated interferon α2b plus ribavirin may be too short to maximize long-term response among patients infected with genotype-1 hepatitis C virus.  J Infect Dis. 2004;  189 964-970
    CrossrefPubMedGoogle Scholar
  • 7 Zeuzem S. Heterogeneous virologic response rates to interferon-based therapy in patients with chronic hepatitis C: who responds less well?.  Ann Intern Med. 2004;  140 370-381
    PubMedGoogle Scholar
  • 8 Jeffers L, Cassidy W, Howell C et al.. Peginterferon alfa 2a (40kd) and ribavirin for black American patients with chronic HCV genotype 1.  Hepatology. 2004;  39 1702-1708
    CrossrefPubMedGoogle Scholar
  • 9 Sturm T, Federman A, Wisnivesky J et al.. Hepatitis C prevalence and risk factors in an urban primary care practice.  J Gen Intern Med. 2004;  19(supp1) 157
    PubMedGoogle Scholar
  • 10 Garfien R, Vahov D, Galai N et al.. Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, HIV, and human T lymphotropic viruses.  Am J Public Health. 1996;  86 655-661
    PubMedGoogle Scholar
  • 11 Dore J, Thomas D L. Management and treatment of injection drug users with hepatitis C virus (HCV) monoinfection and HCV/human immunodeficiency virus coinfection.  Semin Liver Dis. 2005;  25 8-32
    PubMedGoogle Scholar
  • 12 Larson A, Carithers R. Hepatitis C in clinical practice.  J Intern Med. 2001;  249 111-120
    CrossrefPubMedGoogle Scholar
  • 13 Shehab T, Orrego M, Chunduri R, Lok A. Identification and management of hepatitis C patients in primary care clinics.  Am J Gastroenterol. 2003;  98 639-644
    CrossrefPubMedGoogle Scholar
  • 14 Shehab T, Sonnad S, Lok A. Management of hepatitis C patients by primary care physicians in the USA: results of a national survey.  J Viral Hepat. 2001;  8 377-383
    CrossrefPubMedGoogle Scholar
  • 15 U.S. Preventive Services Task Force . Screening for hepatitis C virus infection in adults: recommendation statement.  Ann Intern Med. 2004;  140 462-464
    PubMedGoogle Scholar
  • 16 Falck-Ytter Y, Kale H, Mullen K D et al.. Surprisingly small effect of antiviral treatment in patients with hepatitis C.  Ann Intern Med. 2002;  136 288-292
    PubMedGoogle Scholar

Thomas G McGinnM.D. M.P.H. 

Mount Sinai School of Medicine

Box 1087, 1470 Madison Avenue, New York, NY 10029-6574

Email: thomas.mcginn@mountsinai.org

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