MANAGEMENT OF HEPATITIS-C - A NATIONAL SURVEY OF GASTROENTEROLOGISTS AND HEPATOLOGISTS

A survey on the management of hepatitis C virus (HCV) infection was co nducted by the American Digestive Health Foundation among United State s physicians who are most familiar with the disease. The two-page surv ey was completed by 57% of a random sample of 2,500 members of the Ame rican Gastroenterological Association and the American Association for the Study of Liver Diseases. Analysis was limited to the 1,249 respon ses from physicians who spent at least 1 day per week in patient care. These physicians frequently managed patients with HCV, and nearly thr ee quarters treated patients with interferon. To prevent transmission, the large majority of physicians recommended measures to avoid blood exposures, were uncertain or disagreed about the importance of sexual contact, and did not caution patients about casual contact. More than 70% of physicians told their patients to stop or minimize alcohol cons umption. In the management of a patient with antibody to HCV but norma l serum aminotransferase activities, 87% of physicians would have orde red a supplemental lest, and if HCV mere confirmed, 46% would have obt ained a liver biopsy, but only 15% would have treated the patient with interferon. For a patient with chronic HCV infection and elevated ser um aminotransferase activities, more than 90% of physicians mould have obtained a liver biopsy and approximately 60% would have treated with interferon. Physicians who are most familiar with the management of p atients with HCV generally agreed with the recommendations of the Cons ensus Development Conference Panel regarding prevention of transmissio n, minimizing alcohol consumption, and managing patients with typical presentations, Controversies remain regarding some issues of general m anagement, the value of molecular resting, and the need to treat certa in patients with interferon.