The evaluation of patients with hepatitis C living in rural California via telemedicine.

Patients with hepatitis C who live in rural and low socioeconomic communities often lack access to specialty care. Over the past 7 years, we have provided telemedicine consultations at the Peach Tree Clinic, located in rural northern California. We performed a retrospective analysis of our experience. During this time period we provided consultations for 103 patients with hepatitis C; 37% had cirrhosis, and 64% had never undergone therapy with interferon and ribavirin. Twenty-three percent of the patients were candidates for therapy. The most common contraindication to therapy was the severity of their disease and the risk of decompensation. Fifteen patients were evaluated for liver transplant; 2 were listed but none survived long enough to receive a liver transplant. Our data suggest that there is a large number of patients with hepatitis C and advanced liver disease living in rural communities, some of whom may need treatment or liver transplant. Telemedicine is an effective tool for identifying and treating patients with hepatitis C who live in rural communities.