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ONLINE LEARNING CENTER

CHRONIC HEPATITIS AND HIV (14HC01)

Jiha Slim, MD

 
 
  Release Date: December 1, 2011
EXPIRED: November 30, 2013
Activity Code: 14HC01

IMPORTANT:
CREDIT IS NO LONGER AVAILABLE FOR THIS ACTIVITY.
This content is being provided for informational purposes only.

As seen in the December 2011 edition of


ACTIVITY INFORMATION

Sponsor

Sponsored by the University of Medicine & Dentistry of New Jersey (UMDNJ), Center for Continuing & Outreach Education (CCOE), Division of AIDS Education.

Funding

This activity is supported by an educational grant from the New Jersey Department of Health and Senior Services (NJDHSS) - Division of HIV, STD and TB Services, through an MOA titled “Education and Training for Physicians and other Healthcare Professionals in the Diagnosis and Treatment of HIV/AIDS.”

Target Audience

This free knowledge-based activity is designed for physicians, nurses, pharmacists, social workers, and other health care professionals in New Jersey who are involved in the care of persons with HIV/AIDS and/or hepatitis.

Statement of Need

Chronic hepatitis B (HBV) and C (HCV) infection, added to HIV infection, make both diseases more complex to treat effectively, and significantly increase the risk of liver damage including end stage liver disease (ESLD). In the Multicenter AIDS Cohort Study, men coinfected with HBV were 8 times more likely to die from liver disease than those infected with HIV alone and almost 19 times more likely to die from liver disease than those infected with HBV alone.2

HBV is both preventable and treatable. HBV treatment can readily be combined with HIV therapy, and should lead to complete viral suppression. All HIV medical care programs should incorporate HBV screening and vaccination of all HBV-negative individuals.3

HCV treatment includes few FDA-approved treatment options for HIV co-infected individuals. Clinicians should discuss the prognosis and treatment options with these patients, provide ongoing monitoring and risk reduction counseling addressing alcohol consumption, and provide hepatitis A and B vaccination to non-immune patients.

Co-treatment of HBV or HCV with HIV is associated with risks of adverse physical and psychological effects, requiring ongoing close monitoring. These risks are balanced by the opportunity to minimize and even reverse liver damage, and improve quality and length of life for many co-infected individuals.

Learning Objectives

Upon completion of this activity, participants should be able to:

  1. Screen and monitor HIV patients for hepatitis B and C infection.
  2. Make decisions about treatment initiation and regimens that incorporate recent revisions in treatment recommendations for hepatitis B and C.
  3. Identify challenges of co-management of HIV and Hepatitis B and/or Hepatitis C, including timing of sequential or simultaneous treatment and potential adverse effects and drug interactions.

Faculty

Activity Director(s)/CME Academic Advisor(s)

Patricia Kloser, MD, MPH, Professor of Medicine, UMDNJ-New Jersey Medical School and UMDNJ-School of Public Health.

Planning Committee

Sindy Paul, MD, MPH, FACPM, Medical Director, Division of HIV, STD and TB Services, New Jersey Department of Health and Senior Services.

Debbie Y. Mohammed, MS, MPH, APRN-BC, ACRN, Nurse Practitioner, UMDNJ-University Hospital and St.Michael’s Medical Center – Peter Ho Clinic.

Humberto Jimenez, PharmD, AAHIVE, Infectious Disease Pharmacist, St.Michael’s Medical Center; Clinical Assistant Professor, Ernest Mario School of Pharmacy, Rutgers University.

Kimi Nakata, MSW, MPH, UMDNJ-CCOE-Division of AIDS Education Program Supervisor and Editor, NJ AIDSLine.

Bonnie R. Abedini, MSN, RN, Director, Quality & Compliance, Rutgers University Health Services.

Faculty

Jihad Slim, MD, is an Attending Physician in the Department of Infectious Diseases at St. Michael’s Medical Center in Newark, NJ; Assistant Professor of Medicine, Seton Hall University Graduate School of Medical Education, South Orange, NJ; and Assistant Professor of Medicine, St. George’s University, West Indies.

Method of Instruction

Participants should read the learning objectives, review the activity in its entirety, and then complete the self-assessment test which consists of a series of multiple-choice questions. Upon completing this activity as designed, achieving a passing score of 70% or more on the self-assessment test and submitting a course evaluation, participants will have access to an online printable credit statement. Estimated time to complete this activity as designed is 1.0 hour for physicians, 1.08 hours for nurses, and 1.0 hours for pharmacists.

Accreditation

Credit is no longer available for this activity..

Review

In order to help ensure content objectivity, independence, and fair balance, and to ensure that the content is aligned with the interest of the public, UMDNJ-CCOE has resolved all potential and real conflicts of interest through content review by a non-conflicted, qualified reviewer. This activity was peer-reviewed for relevance, accuracy of content and balance of presentation by Patricia Kloser, MD, MPH; Debbie Mohammed, MS, MPH, APRN-BC, AACRN; Humberto Jimenez, BCPS, PharmD, AAHIVE, Brenda Christian, MEd, PA-C; Director of AIDS Education, UMDNJ-CCOE.

Field Test:
This activity was pilot-tested for time required for participation by Kinshasa Morton, MD; Shobha Swaminathan, MD; Jojy Cheriyan, MD; Mary C. Krug, MSN, APN; Renee Powell, BS, RN; Kara Winslow, BSN, RN; Polly Jen, PharmD; John Faragon, PharmD, AAHIVE; and George Rusuloj, PharmD.

Disclosure Disclaimer

In accordance with the disclosure policies of UMDNJ and to conform with ACCME and FDA guidelines, individuals in a position to control the content of this educational activity are required to disclose to the activity participants: 1) the existence of any relevant financial relationship with any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients, with the exemption of non-profit or government organizations and non-health care related companies, within the past 12 months; and 2) the identification of a commercial product/device that is unlabeled for use or an investigational use of a product/ device not yet approved.

Faculty Disclosure Declarations

There were no relevant financial relationships to disclose reported by the activity director, planning committee members, peer reviewers or field testers.

Jihad Slim, MD has disclosed the following relevant financial relationships: Speaker’s Bureau: Genentech, Merck, Vertex.

Off-Label Usage Disclosure

This activity contains information of commercial products/devices that are unlabeled for use or investigational uses of products not yet approved. Dr. Slim discusses use of the combination of tenofovir + emtricitabine for HBV+HIV co-infected patients, based on clinical trial reports and DHHS guidelines, pending FDA approval.3

Content Disclaimer

The views expressed in this activity are those of the faculty. It should not be inferred or assumed that they are expressing the views of NJDHSS) – Division of HIV, STD and TB Services, any manufacturer of pharmaceuticals or devices, or UMDNJ. It should be noted that the recommendations made herein with regard to the use of therapeutic agents, varying disease states, and assessments of risk, are based upon a combination of clinical trials, current guidelines, and the clinical practice experience of the participating presenters. The drug selection and dosage information presented in this activity are believed to be accurate. However, participants are urged to consult all available data on products and procedures before using them in clinical practice.

Copyright © 2011 UMDNJ-Center for Continuing and Outreach Education. All rights reserved including translation into other languages.No part of this activity may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval systems, without permission in writing from UMDNJ-Center for Continuing and Outreach Education. Please direct CME related questions to UMDNJ at 973-972-4267 or email ccoe@ca.rutgers.edu.


 

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