BLOCK HIV/HCV

Faculty

David L. Wyles, MD (Activity Chair)
Professor of Medicine
University of Colorado School of Medicine
Chief, Division of Infectious Diseases
Denver Health
Denver, Colorado

Stacey Trooskin, MD, PhD, MPH
Director, Viral Hepatitis Programs
Jonathan Lax Treatment Center
Philadelphia FIGHT
Philadelphia, Pennsylvania

Course Description

Approximately 25% of all individuals infected with HIV are coinfected with HCV.¹ Of critical significance, HIV increases the rate of progression of HCV-related hepatic fibrosis, and HCV is associated with a 3-fold increase in HIV antiretroviral therapy-induced liver toxicity.² Further, these synergistic diseases often occur in adverse socioeconomic conditions that significantly increase the vulnerability and decrease the overall health status of at-risk populations.³ Whereas HIV infection is now effectively manageable, chronic HCV infection is curable. Yet, despite new, highly effective direct-acting antiviral treatment regimens for HCV, their broad-scale use and associated therapeutic successes remain stymied by barriers at the patient, clinician, healthcare system, and jurisdictional levels.⁴ The BLOCK HIV/HCV initiative will provide community-based infectious disease specialists and other HIV treaters with foundational information and practical resources needed to prepare local stakeholders -- both clinical and nonclinical -- to collaborate in efforts to eliminate HCV within their communities.

References

1. Centers for Disease Control and Prevention. HIV/AIDS and Viral Hepatitis. https://www.cdc.gov/hepatitis/populations/hiv.htm. Accessed August 30, 2018.
2. Sulkowski MS, Benhamou Y. Therapeutic issues in HIV/HCV-coinfected patients. J Viral Hepat. 2007;14:371-386.
3. Singer M. Introduction to Syndemics: A Critical Systems Approach to Public and Community Health. San Francisco, CA: Jossey-Bass; 2009.
4. National Viral Hepatitis Roundtable (NVHR). Hepatitis C: the State of Medicaid Access. October 23, 2017. https://stateofhepc.org/wp-content/uploads/2017/10/State-of-HepC_2017_FINAL.pdf. Accessed August 30, 2018.

Target Audience

This activity is intended for a multidisciplinary audience including community-based infectious disease specialists and other human immunodeficiency virus (HIV) treaters, gastroenterology/hepatology clinicians, mental health specialists, substance abuse specialists, correctional healthcare professionals, public policy/public health officials, hepatitis C virus (HCV) and HIV advocacy groups, payers, and clinical office staff who are engaged in the care of patients with HIV and/or HCV.

Educational Objectives

Upon completion of this activity, participants will be better able to do the following:

• Describe epidemiologic trends in HCV monoinfection and HIV/HCV coinfection within at-risk populations, including men who have sex with men (MSM), people who inject drugs (PWID), and incarcerated individuals
• Screen MSM, PWID, and incarcerated individuals for HCV and HIV infection
• Provide guideline-based treatment for HCV monoinfection and HIV/HCV coinfection
• Identify patient, provider, and healthcare system barriers to effective management of HCV monoinfection and HIV/HCV coinfection
• Implement strategies to overcome risk-cohort–specific challenges to the treatment of HCV monoinfection and HIV/HCV coinfection

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest (COI) they may have as related to the content of this activity. All identified COI are thoroughly vetted and resolved according to PIM policy. PIM is committed to providing its learners with high quality activities and related materials that promote improvements or quality in health care and not a specific proprietary business interest of a commercial interest.

David L. Wyles, MD: Served as an advisor or consultant for: AbbVie Inc., Gilead Sciences, Inc., Merck & Co., Inc. Received grants for clinical research from: Gilead Sciences, Inc.

Stacey Trooskin, MD, PhD, MPH: Received grants for clinical research from: Gilead Sciences, Inc

Non-faculty

The PIM planners and managers have nothing to disclose. The Integritas Communications planner and manager, Jeanette Ruby, MD, has nothing to disclose.

Financial Support

This activity has been supported by independent educational grants from Gilead Sciences, Inc., Merck & Co., Inc., and AbbVie Inc.

Provider Information

In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and Integritas Communications. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.

The Postgraduate Institute for Medicine designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CME Inquiries/Special Needs

For questions regarding the accreditation of this program, please contact Postgraduate Institute for Medicine (PIM) at www.pimed.com.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Method of Participation and Request for Credit

There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page. To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 70% on the post-test.

Follow these steps to earn CME/CE credit:

1. Read the target audience, learning objectives, and author disclosures.
2. Study the educational content online or printed out.
3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. In addition, you must complete the Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates from the CME/CE Tracker.