Posted on July 27, 2014
Source: Allaa Mageid, 2014 Baltimore HIV/AIDS Scholar
Hepatitis C (HCV) is a rising issue nationally, with the number of HCV related deaths surpassing those related to HIV every year . It is estimated that in the United States, the prevalence of HCV is 2%; however, the problem is exacerbated in the Baltimore City population with a 6% infection rate according to our preliminary data from the rate at which HCV is being diagnosed at the clinic here. Risk factors for HCV include being in the birth cohort 1945-1965, currently injecting drugs, or ever having injected drugs, and receiving a blood transfusion or organ transplant prior to 1992. HCV is a life-threatening disease that can become chronic and lead to liver cirrhosis and cancer eventually in 75-85% of people infected with it. While working at the Baltimore City STD clinic, I have become intimately engaged with these issues as the cascade of care for patients with HCV can be challenging. By the end of the “cascade”, only a small amount of people whose test result came up positive, approximately 5%, receive the proper care they need .
In the past, HCV was notorious for an awful treatment that included shots that make you feel sick and thus patients did not happily ascribe to it, as the disease itself is mostly asymptomatic in its early stages. However, with advances in medical technologies, two new treatments with minimal side effects and close to 100% cure rates are on the market. The main question then becomes why don’t primary care physicians test and treat HCV in their offices instead of referring them to tertiary care? This is the question that I am currently researching. This summer I conducted a literature review of how primary care doctors contribute to treating HCV patients presently, their attitudes and perceptions of treating HCV, and why much is not being done in their office and what could motivate them to treat HCV in their offices. Currently, I am also conducting a needs assessment of doctors’ offices in Baltimore City. I am piloting the needs assessment survey this week. Additionally, I am administering Linkage to Care Barriers Questionnaire to all of our patients that have tested positive for HCV Virus since the naissance of this project to gauge where they are with seeing a physician who could treat their infection.
Day to day, I serve as a HCV rapid tester at the Baltimore Health Department clinic where I test blood samples for the virus. I have acquired vast knowledge about disease surveillance and how government-run agencies operate. So far, my experience at the Baltimore City Public Health Department has been truly enriching and I look forward to continuing my work here over the summer and submitting an abstract to the National Harm Reduction Conference this fall.
