Hepatitis C knowledge among primary care residents: is our teaching adequate for the times?
BACKGROUND
Increasingly, primary care (PC) physicians will be the first to encounter patients with hepatitis C virus (HCV) infection.


OBJECTIVE
To determine opinions and practices of PC residents regarding HCV.


METHODS
We administered a one-page questionnaire to 180 PC residents at five U.S. training programs.


RESULTS
Respondents were distributed equally across postgraduate year, 83% were U.S. graduates, and 44% had seen >11 (HCV) patients in the past year. Residents tested for HCV in persons with: increased transaminases (83%), history of blood transfusion (46%), multiple tattoos (57%), +ANCA (16%), and alcohol abuse (31%). Sixteen percent of respondents tested all patients. Forty-one percent would vaccinate HCV patients for hepatitis A and 65% for hepatitis B while only 19% and 78% knew the respective vaccination schedules. Although no vaccine is available, 66% recommended vaccination for HCV. Only 37% and 29%, respectively, reported HCV genotype 1 as most common and most resistant to treatment. Fifty-three percent recommend liver biopsy before treating HCV. Only 52% reported alpha-interferon (IFN) with ribavirin as initial treatment for HCV while 28% recommend ribavirin or lamivudine alone or combinations of IFN and lamivudine or amantadine. As contraindications to treatment, 33% reported AIDS with PCP infection, 19% coronary artery disease, and 19% suicidal ideation. Sixty-nine percent felt that there was insufficient information on HCV.


CONCLUSIONS
Many PC residents lack adequate knowledge of recommended guidelines for the management of HCV. Many test for HCV in inappropriate situations, are unclear regarding available vaccines and their administration, and are uncertain about current treatment. Education of PC residents on guidelines for detection and management of HCV must be improved.
Division of Gastroenterology and Hepatology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Angelo G
AG
Coppola
Pietor C
PC
Karakousis
David C
DC
Metz
Mae F
MF
Go
M
M
Mhokashi
Colin W
CW
Howden
Jean-Pierre
JP
Raufman
Virender K
VK
Sharma
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001130:Arizona; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D004503:Education, Medical, Graduate; D005194:Family Practice / Q000193:education; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006526:Hepatitis C / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007388:Internal Medicine / Q000193:education; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013663:Teaching
D000998:Antiviral Agents