Ep 200 – Hepatitis C
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In this special episode of the GPnotebook Podcast, Dr. James Waldron is joined by Dr. Rick Fetan, a GP partner and hepatitis C GP champion in Southeast London, to discuss the transformative advances in the diagnosis and treatment of hepatitis C. Once considered a chronic, incurable condition with limited treatment options, hepatitis C is now curable in over 98% of cases using oral, once-daily direct-acting antivirals with minimal side effects. The conversation highlights the critical role of primary care in identifying asymptomatic patients through targeted testing—especially in high-risk groups such as people with a history of intravenous drug use, men who have sex with men, individuals from high-prevalence regions, and those who received blood transfusions before 1996. Dr. Fetan emphasizes the importance of normalizing conversations around hepatitis C testing, avoiding stigma, and using routine liver function tests as an opportunity to screen. The NHS Hepatitis C Elimination Programme, supported by cross-sector collaboration and the 2024 Infected Blood Inquiry, has driven progress in diagnosis and treatment access. Despite these advances, an estimated 50,000 people in the UK remain undiagnosed, making proactive screening in primary care essential. The episode concludes with a call to action for GPs to remain vigilant, retest patients with ongoing risk factors, and continue expanding awareness to achieve elimination goals. Key takeaways include: (1) Hepatitis C is now curable with a 12-week oral treatment regimen with near-perfect efficacy; (2) Primary care is pivotal in identifying undiagnosed cases through routine testing and risk-based screening; (3) Normalizing conversations about hepatitis C reduces stigma and improves patient engagement; (4) Patients can be reinfected, so ongoing risk assessment and retesting are crucial; (5) The NHS Hepatitis C Elimination Programme exemplifies successful integration of community and hospital care. The episode ends with a teaser for the next in the hepatology series: hepatitis B.
Hepatitis C is now curable with 98–99% success rates using a 12-week oral treatment regimen.
Primary care plays a critical role in identifying asymptomatic patients through targeted screening based on risk factors.
Normalizing the conversation around hepatitis C testing reduces stigma and improves patient willingness to be tested.
Patients can be reinfected after cure, so ongoing risk assessment and retesting are essential.
The NHS Hepatitis C Elimination Programme has successfully shifted care from hospitals to communities, improving access and outcomes.
Introduction to Hepatitis C and the Special Guest
Dr. James Waldron welcomes Dr. Rick Fetan, a GP partner and hepatitis C GP champion in Southeast London, to discuss the transformative advances in hepatitis C care and the role of primary care in the NHS elimination programme.
Why Hepatitis C Is a Game-Changer in Primary Care
“It's a real success story, I would say. And I guess that this puts it on one of the top of the things that we want to do...”
The NHS Hepatitis C Elimination Programme and Public Health Impact
“The NHS Hepatitis C elimination programme has really is an example of how we can move sort of care from hospitals to the community...”
Risk Factors and the Art of Asking the Right Questions
“Just being curious. Yeah, I mean, we can imagine it can be challenging conversations in... in a lot of respects.”
Testing Strategies and Interpreting Results
The team outlines when to test—such as abnormal LFTs, non-specific symptoms, or known risk factors—and explains how to interpret antibody and RNA testing, including the importance of retesting after exposure.
“Patients are receiving hepatitis C positive organs. organ transplant and they are then being started immediately post-operatively on hepatitis C treatment because it's that effective.”
“Most patients will be successfully treated this doesn't mean they can't be reinfected... still think about offering a new test.”
“It's a real success story, I would say. And I guess that this puts it on one of the top of the things that we want to do...”
Host
Guest
Dr Rick Fetan
person
Dr James Waldron
person
NHS Hepatitis C Elimination Programme
other
Direct-Acting Antivirals
other
Liver Function Tests
other
Antibody Testing
other
GPnotebook Podcast
media
Hepatitis B
other
HIV
other
RNA Testing
other
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