Friday, September 7, 2012

Weekend Reading -Your Patient Tests Positive for HCV: Now What?

 
Weekend Reading
 

Painting By - Pablo Picasso
 
Hello folks,
Each weekend this blog offers a continuing series of education-related information on hepatitis C. This weekend we jump over to Medscape for a three part activity exploring the latest issues related to the ongoing challenges of managing viral hepatitis. The CME is available in a video format which includes a transcript and slides of each presentation.
 
*Free registration is required, click here to register, and here to view video webcast.
 
*When the popup window appears click on "Continue to Activity"
 
Part 1-Video/CME Webcast
CDC Recommendations: One-Time HCV Testing and Linkage to Care for Persons Born 1945-1965
About 1 in 30 persons born between 1945 and 1965 are HCV infected; half are unaware.
John W. Ward, MD
Available As: Slides/Video - Download Slides - Transcript
 
Summary
The CDC views HCV infection as a critical public health issue for the nation. The mortality from HCV infection is rising. The mortality rate increased by 50% from 1999 to 2007. Deaths from HCV infection now surpass the number of deaths associated with HIV/AIDS; approximately 16,000 people die from HCV infection every year in the United States. A conservative estimate based on national health surveys is about 3.2 million Americans are living with HCV infection. Two out of 3 of these persons were born between 1945 and 1965. The CDC estimates are that 1 out of every 3 persons living with HCV infection today will die prematurely due to their HCV infection.
 
Part 2-Video/CME Webcast
HCV transmission was epidemic in the United States from the 1960s through the 1980s, leading to a current estimated prevalence of chronic HCV infection of 4 million. According to large, population-based, epidemiologic surveys in the United States, groups such as men between the ages of 40 and 50 years have a prevalence of chronic HCV infection of up to 6%. Men in this group are expected to live another 20 or 30 years. Thus, those who were infected in the 1960s through the 1980s are now at high risk for to developing long-term complications, including cirrhosis and hepatocellular carcinoma (HCC).
Hashem B. El-Serag, MD, MPH
Available As: Slides/Video - Download Slides - Transcript
 
Summary
Looks at the transmission of HCV in a healthcare setting. The prevalence of cirrhosis and Liver cancer with underlying hepatitis C infection. As noted in the presentation - Liver cancer has become the fastest rising cause of cancer-related deaths in the United States, at a time when deaths related to all kinds of cancer are declining. Mortality rates for only a few types of cancers are increasing, and liver cancer leads the way.
 
Part 3-Video/CME Webcast
Your Patient Tests Positive for HCV: Now What?
A positive HCV screening test should be followed by a confirmatory test and when indicated, linkage to care for HCV treatment.
W. Ray Kim, MD
Available As: Slides/Video - Download Slides - Transcript
 
Summary
The last part of the CME will discuss the (FDA)-approved HCV screening tests, physical examination, clinical evaluation, assessment of fibrosis, herbal products, and the risk of transmission. Also included; which hepatitis C patients should be treated and when to begin therapy.
 
In Case You Missed It
 
Donald M. Jensen, MD; Mark S. Sulkowski, MD
Faculty and Disclosures

CME/CE Released: 09/04/2012

Watch Video Or Read Transcript
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*When the popup window appears click on "Continue to Activity"
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Transcript excerpt:
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Mark S. Sulkowski, MD: Hello. I am Dr Mark Sulkowski, professor of Medicine and medical director of the Viral Hepatitis Center at the Johns Hopkins University School of Medicine in Baltimore, Maryland. I would like to welcome you to this program, "Chronic Hepatitis C Infection: Treat Now or Wait?" Joining me today is Dr Donald Jensen, professor of medicine and director of the Center for Liver Diseases at the University of Chicago School of Medicine.
Before we get started, I would like to note that a lot of what we are going to discuss is on investigational drugs: not everything we are going to talk about is approved for prescription in the United States at this time. To have this discussion, we need to talk about what is currently approved for the treatment of chronic hepatitis C virus (HCV) infections and what we hope will be available for our patients in the near future. Don, why talk about whether to treat now or wait? Give us a scenario.

Donald M. Jensen, MD: As you know, 13 months ago, 2 new drugs, telaprevir and boceprevir, were approved for the treatment of chronic HCV infection in conjunction with the standard pegylated interferon/ribavirin backbone regimen. Telaprevir- and boceprevir-based triple therapy proved very effective in improving sustained virologic response (SVR) rates in patients with genotype 1 HCV infection, but also exacerbated some of the adverse effects associated with standard interferon-based therapy. The course of therapy is still relatively long in duration, usually 24 or 48 weeks. With the prospect of newer therapies becoming available sooner than anticipated, we need to consider that some of our patients may be able and inclined to wait for treatment with future therapies that might be easier to take, better tolerated, and have shorter courses of treatment compared with the standard regimens used today.

Continue Reading.......

Watch Video

From Medscape Education Infectious Diseases
 
Projects In Knowledge

Over at "Projects In Knowledge" readers will find eight chapters of hepatitis C information in the newly updated "Living Medical eTextbook". Added in August was "Chapter 8-Treating HCV In Special Populations" with "Chapter 9-Predictors Of Response" coming in October, all chapters with links are provided below.

Although, like any site offering continuing medical education (CME), it requires a free quick registration.

Navigating The CME

1- Either log in or register at "Projects In Knowledge".
2- Click on chapter links below, or at  the website. Each link will take readers to the first page of the CME index, scroll down and click on "launch activity."
3- Pretest-Participant's have the option to skip the pretest and go directly to the CME by clicking - "No thanks, Proceed to the activity" 
 

     
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