Re:Important Info

[Guest guest]

Jackie....I found some important info.....skip the stuff on HIV and whatever

you don't understand.....read it all specially the last section...

They have known for a long time Jackie.....

They knew hep C affects the brain causing depression.....it shows on

MRI's....and they knew that leptin levels from insulin resistance cause the

fatigue....they knew the neutropenia (low neutrophils) is caused by the virus

not the

interferon.......they knew that ALL hep C patients have some level of insulin

resistance and it causes fatty liver..........

they knew how important diet was but didn't educate anybody about it.....they

think it's " interesting " to watch you like lab rats....

Silvia

http://www.hcvadvocate.org/hepatitis/About_Hepatitis_pdf/1.1.1_Living_With_Hep

atitisC/SIDE_EFFECTS.pdf

P.S. and the primary care doctors ?

Abstract ID: M1236

Knowledge and Practices Of Internal Medicine Residents in the Management Of

Chronic Hepatitis C (HCV) Infection: a Prospective Multicenter Survey

Authors: J.K. Lim, J.S. Ng, D.D. Proctor

BACKGROUND/AIMS

Primary care physicians may be inadequately prepared to evaluate and manage

patients with chronic HCV infection. Identification of specific areas of

knowledge deficit among internal medicine residents may provide targets for

educational intervention.

METHODS

We administered a structured 1-page survey assessing knowledge and practices

regarding HCV infection to 251 internal medicine residents at 8

ACGME-accredited U.S. training programs.

RESULTS

Residents were equally distributed among three post-graduate years. 89.6%

were U.S. medical graduates, most were enrolled in traditional (64.9%) or

primary

care (22.7%) programs, and nearly all (98.0%) had seen patients with HCV

within the past year, 60.6% of whom had seen >10 patients. Although most screen

for HCV in patients with abnormal LFT’s (85.3%), prior needlestick exposure

(82.1%), prior IVDU (80.9%), or HIV co-infection (77.7%), few performed

screening

in other at-risk populations, including individuals with a history of

transfusion (59.8%), snorting cocaine (26.7%), or incarceration (21.5%). Only

45.5%

and 36.7%, respectively, use the diagnostic tests HCV PCR and genotype

appropriately. Only a fraction vaccinate HCV (+) patients for protection against

HAV

(33.1%) or HBV (61.4%), and few were familiar with recommended vaccination

schedules, 19.5% and 64.5%, respectively. Some report they vaccinate HCV (-)

individuals with HCV vaccine (20.3%) ALTHOUGH IT DOES NOT EXIST. Only 25.5% and

22.3%, respectively, correctly identified genotype 1 as the most common in the

U.S., and least responsive to antiviral therapy. Only 30.7% named HCV as the #1

indication for liver transplantation. Although most correctly cited EtOH

(80.5%), HIV (75.3%), and HBV (64.1%) as risk factors for disease progression,

only

10.0% and 14.7%, respectively, correctly estimated the rate of chronic

viremia following exposure, and risk for developing cirrhosis at 20 yrs of

infection. Only 35.5% identified IFN/RV or PEG-IFN/RV as 1st line antiviral

therapy –

30.7% incorrectly named lamivudine. FEW RESIDENTS FEEL ADEQUATELY TRAINED IN

HCV MANAGEMENT (23.9%).

http://www.hcvadvocate.org/news/reports/DDW_2005/May%2016%20HCV.htm