Dr Dylan Phillips, GP
What's the profile of your ‘average' patient?
Hepatitis C doesn't discriminate and anyone can become infected if they're exposed to it. Since hepatitis C infection doesn't usually cause symptoms for many years, the challenge for us as healthcare professionals is to identify those at risk of infection and offer testing, as effective treatment is available.
What initially triggers you to test for hepatitis C?
We try to identify whether a patient may have ever been at risk of hepatitis C infection. We would recommend the patient be tested if they have ever: injected drugs; had a tattoo or piercing using unsterilised equipment; received medical or dental treatment abroad where unsterile equipment may have been used or received a blood transfusion before 1991 or a blood product before 1986.
How do you manage initial reaction and shock?
It's important to consider a support network for the patient at an early stage. It may be useful to direct them to local and national support services. The Hepatitis C Information Line (0800 451 451) gives patients information about hepatitis C transmission, testing, diagnosis and treatment. The Hepatitis C Trust Helpline (0845 233 4424) is staffed by people who have experience of hepatitis C and provides support for those diagnosed.
What lifestyle changes do you recommend?
Reduction or total abstinence from alcohol and advice on safe sex. Also, if the patient is overweight, we would look at ways in which we can support weight reduction.
What are the key challenges in managing the process from diagnosis to treatment?
Its vital to make sure that the patient has all the support they need to attend their appointments, whether they are at the surgery or the hospital. Patients often need help and encouragement to do so.
Has your experience in treating patients with hepatitis C altered your outlook towards testing more at risk patients?
Yes, we definitely test much more widely now as outcome of treatment is now so much better. The effective treatments for hepatitis C that are available mean that on average over half of those accessing treatment will be cured. Different strains of the virus are more responsive than others, but early diagnosis can significantly help a patient's chance of recovery.
Shabana Begum, Hep C Patient, 41
How did you become infected with hepatitis C?
I believe that I was infected with hepatitis C whilst undergoing medical treatment in Pakistan, where I lived as a young woman in the 70s.
When were you diagnosed?
I was one of the few people who actually experienced any symptoms. In 2004, I wasn't feeling very well generally. I didn't have much energy at the time and so I went to my GP who conducted a series of tests, which told me that I had hepatitis C.
What treatment did you undergo?
After a combination of pegylated interferon alpha and ribavirin for 6 months, I managed to clear the virus.
After diagnosis, how did you initially cope with the shock and stigma that surrounds hepatitis C?
I was really upset at first, I instantly thought my life was going to come to an end. Also I did experience a lot of stigma from my community, but I never hid the fact that I had the virus.
It was recommended that I go to a support group called the Peacock Project. It was really helpful for me to meet other people with hepatitis C, and to meet other people who were undergoing treatment.
How vital was the relationship between yourself and your GP in helping you come to terms with the diagnosis and treatment?
My GP was very supportive through diagnosis and he helped me deal with the side effects of the treatment. He always made time to sit down and chat with me, which was a real help through the tough times.
What message would you like to send to GPs about the importance of raising awareness of hepatitis C?
Be open-minded about who you test. Being aware of hepatitis C can save your patient's life. Also, being diagnosed with hepatitis C and undergoing treatment can be really tough so GPs need to realise how important it is to offer support.