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Folsom, California Office: 916-983-4444

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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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Lonafarnib for chronic hepatitis delta

Jun 10, 2026

Lonafarnib for chronic hepatitis delta: Clinical mechanism of action, development, and evolving role in combination therapy

Hepatitis D virus (HDV), the smallest known human RNA virus, is a defective, satellite virus that requires hepatitis B virus (HBV)-derived surface antigen (HBsAg) proteins for virion assembly and entry (Gopalakrishna et al., 2024). HDV superinfection occurs when a person with existing HBV infection subsequently becomes infected with HDV, resulting in the most severe form of chronic viral hepatitis, accelerating progression to cirrhosis, hepatic decompensation, hepatocellular carcinoma (HCC), and death (Gopalakrishna et al., 2024). Coinfection of HBV and HDV, ie, simultaneous infection, can result in fulminant hepatic failure, although most infected individuals can clear both HBV and HDV, if infected as adults. The original discovery of delta antigen in HBsAg carriers, and subsequent characterization of the delta agent as an RNA-containing particle associated with HBsAg, established HDV as a distinct viral pathogen dependent on HBV envelope proteins (Rizzetto et al., 1977, 1980). While HDV can replicate its genome autonomously inside the hepatocyte, the virus requires HBsAg, rather than complete HBV replication, to complete virion assembly and to facilitate transmission.

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