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Study finds troubling trends in hepatitis C screening, diagnosis and referral

Primary care doctors and their patients need to be more aware of risk factors, need for testing

ANN ARBOR, MI - People who might be infected with the potentially fatal hepatitis C virus are not getting tested early or often enough, possibly because neither they nor their primary doctors are raising the issue, a new University of Michigan Health System study finds. And even if they do test positive for the virus, they may not always get referred for specialty care.

The study's results suggest an urgent need for better awareness among both physicians and the public about the risk factors for hepatitis C. The authors say better mechanisms may be needed to help busy doctors identify those at risk and ensure they get tested while there is still time to refer them for treatment - treatment that may help them fight the infection and stave off liver failure.

The new study finds that among a sample of the 2,348 hepatitis C screening tests ordered by primary care physicians, only a quarter of the tests were ordered because the doctor identified the patient as having a potential risk factor, such as intravenous drug use or a blood transfusion before 1992. Another 65 percent had the test because of prior liver problems or because routine blood tests showed elevated liver enzymes. Ten percent of patients requested it.

Of all those tested, 10 percent turned out to be infected, and about half were referred to a specialist for follow-up. Meanwhile, almost half of the 57 patients who tested positive and went on to have a liver biopsy turned out to have significant liver scarring, either cirrhosis or fibrosis, suggesting a longstanding infection.

The results will be presented May 21 at the Digestive Disease Week meeting in Atlanta, by U-M Medical School gastroenterology professor Anna Lok, M.D., fellow Thomas Shehab, M.D., and visiting fellow Mauricio Orrego, M.D.

"Primary care doctors are the gatekeepers of the health care system, and it's
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
20-May-2001


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