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WHO:

Dr. Gish is a Hepatologist specializing in all forms of liver disease, liver cancer and liver transplant. Dr. Gish has partnered with TeleMed2U to provide telemedicine consultative services for patients with liver disease.

WHAT:

TeleMed2U is a telemedicine-based multi-specialty clinical practice increasing access to specialist providers providing, “healthcare anywhere and everywhere.” The telemedicine consultation will be conducted through our HIPAA and HITECH compliant platform. Connectivity testing will be done in advance to ensure you can connect via our telemedicine platform. Following the consultation, a clinical note will be provided including a summary of your liver consultation with Dr. Gish and his consultative recommendations.

COST:

Payment will be processed through an online secure transaction portal. The fees for consultative services are:

Initial 60 minute consultation per patient: $500.00
Follow Up 30 minute consultation per patient: $300.00

NEXT STEPS:

If you’d like to continue, please click Next to complete the form and we will contact you to schedule connectivity testing. During the test you will have the opportunity to determine the method of providing medical records, discuss appointment availability as well as discuss any additional questions that you have. If you are a healthcare facility interested in services, please complete the form and we can discuss the options that are right for you and your patients.

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You should be aware of the general risks of transmitting information over the Internet, which may not use encryption. You should therefore not share any personal medical information that you would wish to be held confidential in a physician/patient or similar clinical relationship.

The information contained on this website is not intended, should not substitute for, or be used instead of, a clinical or therapeutic relationship with a health care professional who is fully familiar with the specifics of your case. The information on this site may assist you in your personal, general research but none of it constitutes the practice of medicine or any other health care profession.

Nothing in this site is intended as a recommendation or endorsement of any specific tests, products, procedures, healthcare provider, opinions, or other information that may be mentioned in this site. Any reliance on any information provided by the website personnel, others appearing on the site at the invitation of the website and/or other visitors to the site is solely at the user's risk.

E-mail correspondence with Dr. Robert G. Gish Consultants, LLC or any of its employees, or agents, does not create a physician/patient relationship between us or cause Dr. Gish to create or retain any medical records about you, monitor your care, or communicate with your own health care provider.

Always seek the advice of your physician or other qualified health care provider with any questions you have regarding your medical care. If you suspect that you may have a medical condition, or are seeking medical advice or treatment, we recommend that you consult a qualified health professional as soon as possible.

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Rare Disease Database - Hepatitis B

May 3, 2021

Rare Disease Database - Hepatitis B

Hepatitis D is a liver disease caused by the hepatitis delta virus (HDV). HDV is known as a “satellite virus” or an “incomplete virus” because it can only infect people who are also infected with the hepatitis B virus (HBV). Patients with an HDV infection may have an acute co-infection (an infection discovered at the same time as HBV) or a new or “superinfection” (when a patient already infected with HBV later acquires HDV). Both forms of infection can cause a chronic, long-term illness. Age of onset can occur at birth through mother to child transmission (rare), and more importantly, can occur through infection as an adult. Chronic HDV is one of the most severe forms of viral hepatitis (liver inflammation due to a viral infection) and causes more severe liver disease than having chronic HBV infection alone. Chronic HDV is also associated with a more accelerated progression of liver disease, a higher risk of liver cancer and early development of liver complications in patients who have already developed cirrhosis (end stage liver disease), liver failure, liver transplant, and death. An accurate prevalence of HDV is unknown given there is suboptimal awareness 2/8 and testing for this disease both domestically and globally. However, recent studies estimate that the prevalence of HDV ranges from 12 to 74 million individuals affected worldwide, and it likely affects 5-10% of patients with chronic HBV infection. This emphasizes the need for further research and data in order to formulate an accurate estimate of HDV prevalence and to understand which individuals are at greatest risk of HDV infection. Despite the severity of this disease and how quickly it can lead to liver damage and deterioration, there are no current recommendations from the Centers for Disease Control (CDC) or World Health Organization (WHO) to make this a reportable disease, and there are no FDA-approved therapies available for HDV treatment. One medication called bulevirtide (Hepcludex, Myr/Gilead Sciences) is approved in Europe. In addition, there are many promising therapies for HDV on the horizon.

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