A survey of Australian general practice management of hepatitis C-infected patients from non-English-speaking backgrounds.
BACKGROUND
Australia receives many migrants from countries with a high prevalence of hepatitis C infection. General practitioners, who are often the first health professionals consulted, need to be aware of risk factors and complications associated with hepatitis C in this group.


METHODS
Four hundred and forty-seven general practitioners, obtained from registries at two Melbourne teaching hospitals serving large non-English-speaking migrant populations, were sent a questionnaire. Two hundred and forty-one returned a completed questionnaire. The survey attempted to assess knowledge of risk factors, complications, currently recommended antiviral therapy, referral practice to specialists and difficulties encountered by practitioners and patients in accessing information about HCV.


RESULTS
Sexual and vertical transmission were listed as more common risk factors than iatrogenic causes or injecting drug use. Most respondents interpreted basic diagnostic tests correctly but there was a range of estimates regarding progression to cirrhosis and hepatocellular carcinoma with many seriously overestimating these aspects of natural history. Interferon and ribavirin were commonly listed as optimal therapy, but both interferon monotherapy and lamivudine, a treatment for hepatitis B, were stated as optimal therapy by 25% of respondents. Considerable frustration was expressed regarding access to reliable information about treatment outcomes and to linguistically and culturally appropriate patient information.


CONCLUSIONS
The wide response range regarding modes of acquisition of HCV in patients from non-English-speaking backgrounds, rates of progression to cirrhosis and hepatocellular carcinoma and optimal antiviral therapy suggests a need to improve provision of appropriate educational resources that will facilitate general practice management of a common and important public health problem.
Dev
Anouk
A
Monash University Department of Medicine, Monash Medical Center, Melbourne, Victoria, Australia. Anouk.Dev@med.minash.edu.au
Sievert
William
W
D019380:Anti-HIV Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D004641:Emigration and Immigration; D005194:Family Practice; D019538:Health Care Surveys; D006526:Hepatitis C / Q000453:epidemiology / Q000628:therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D019259:Lamivudine / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology
D019380:Anti-HIV Agents; D000998:Antiviral Agents; D019259:Lamivudine; D012254:Ribavirin; D007372:Interferons