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eViralHepatitis Review
VOLUME
2, ISSUE 7
Human Immunodeficiency Virus and
Hepatitis C Virus Coinfection
In this Issue...
Hepatitis C virus (HCV) coinfection is common in people with human immunodeficiency virus (HIV). Recent reports highlight the importance of continuing transmission of HCV among HIV–infected men who have sex with men (MSM) and of the impact of HCV infection relative to that of HIV infection on mortality rates in the United States. Further, in an era of effective antiretroviral therapy, liver disease caused by HCV is a clinically significant issue among patients infected with HIV, emerging in some studies as the second leading cause of death in this population.
In this context, treating HCV infection is recommended for patients with coinfection who have significant hepatic fibrosis. New data indicate that people who have HIV/HCV coinfections may benefit from HCV treatment with regimens that include the HCV NS3/4A protease inhibitors telaprevir (TPV) and boceprevir (BOC), in combination with peginterferon plus ribavirin (Peg–IFN/RBV). However, the use of such regimens is complicated by drug–drug interactions with antiretroviral therapy, a paucity of published data, and the lack of an approved indication for treating patients with coinfections.
In this issue, we review the current literature describing the sexual transmission of HCV in HIV–infected MSM, the impact of HIV and HCV on mortality rates in the United States, and treating HCV with TPV or BOC in combination with Peg–IFN/RBV in patients infected with HIV.
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LEARNING
OBJECTIVES |
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After completing this activity, the participant will demonstrate the ability to:
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Describe the role of sexual transmission of hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected men who have sex with men
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Discuss the relative impact of HIV, HCV, or both on mortality rates in the United States |
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Identify the potential benefits and risks associated with the use of HCV NS3/4A protease inhibitors for treating HCV in persons infected with HIV |
The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.
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IMPORTANT CME/CE INFORMATION |
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Accreditation Statements
Physicians
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Johns Hopkins University School of Medicine and The Institute for Johns Hopkins Nursing. The Johns Hopkins University School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.
Nurses
The Institute for Johns Hopkins Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
The Institute for Johns Hopkins Nursing and the American Nurses Credentialing Center do not endorse the use of any commercial products discussed or displayed in conjunction with this educational activity.
credit designations
Physicians
eNewsletter: The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 1.0 AMA PRA Category1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Podcast: The Johns Hopkins University School of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses
eNewsletter: This 1 contact hour Educational Activity is provided by The Institute for Johns Hopkins Nursing. Each newsletter carries a maximum of 1 contact hour or a total of 7 contact hours for the 7 newsletters in this program.
Podcast: This 0.5 contact hour Educational Activity is provided by the Institute for Johns Hopkins Nursing. Each podcast carries a maximum of 0.5 contact hour or a total of 2.5 contact hours for the 5 podcasts in this program.
successful completion
To successfully complete this activity, participants must read the content, and then link to the
Johns Hopkins University School of Medicine's website or the Institute for Johns Hopkins Nursing’s website to complete the post-test and evaluation. Once you receive a passing grade, you can access and print your certificate of credit.
NOTE: If you have already registered for other Hopkins CME programs on their prospective websites simply enter the requested information when prompted.
There are no prerequisites for this activity.
This activity is supported by an educational grant from Gilead Sciences, Inc. and Vertex Pharmaceuticals.
Launch Date
January 31, 2012; activities expire 2 years from the date of publication.
Internet CME Policy
The Office of Continuing Medical Education (CME) at the Johns Hopkins University School of Medicine is committed to protecting the privacy of its members and customers.
The Johns Hopkins University SOM maintains its Internet site as an information resource and service for physicians, other health professionals, and the public.
Continuing Medical Education at the Johns Hopkins University School of Medicine will keep your personal and credit information confidential when you participate in an Internet-based CME program.
Your information will never be given to anyone outside of the Johns Hopkins University School of Medicine program. CME collects only the information necessary to provide you with the services that you request.
Disclaimer Statement
The opinions and recommendations expressed by faculty and other experts whose input is included in this program are their own. This enduring material is produced for educational purposes only.
Use of the Johns Hopkins University School of Medicine name implies review of educational format design and approach. Please review the complete prescribing information for specific drugs or combinations of drugs, including indications, contraindications, warnings, and adverse effects, before administering pharmacologic therapy to patients.
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Statement of Responsibility
The Johns Hopkins University School of Medicine takes responsibility for the content, quality, and scientific integrity of this CME activity.
Intended Audience
This activity has been developed for hepatologists, primary care physicians, infectious disease specialists, nurses, nurse practitioners, and others involved in the care of patients with viral hepatitis.
Planner Disclosure
As a provider accredited by the Accreditation Council for Continuing Medical Education (ACCME), it is the policy of the Johns Hopkins University School of Medicine Office of Continuing Medical (OCME) to require signed disclosure of the existence of financial relationships with industry from any individual in a position to control content of a CME activity sponsored by OCME.
Members of the Planning Committee are required to disclose all relationships, regardless of their relevance to the activity content. Faculty are required to disclose only those relationships that are relevant to their specific presentations. The following relationships have been reported for this activity:
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Mark S. Sulkowski, MD, has disclosed that he has served as a consultant for Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol Myers-Squibb, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, and Vertex Pharmaceuticals. He also has received grants and research support from, Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., Bristol Myers-Squibb, Gilead, Janssen, Merck, and Roche, and Vertex Pharmaceuticals. |
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Raymond T. Chung, MD, has disclosed that he has received grants/research support from Gilead, Pfizer, Roche/Genentech, Merck, and Romark. |
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No other planners have indicated that they have any financial interests or relationships with a commercial entity. |
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Guest
Authors Disclosures |
Confidentiality Disclaimer for Conference Attendees
I certify that I am attending a Johns Hopkins University School of Medicine CME activity for accredited training and/or educational purposes.
I understand that while I am attending in this capacity, I may be exposed to "protected health information," as that term is defined and used in Hopkins policies and in the federal HIPAA privacy regulations (the Privacy Regulations). Protected health information is information about a person's health or treatment that identifies the person.
I pledge and agree to use and disclose any of this protected health information only for the training and/or educational purposes of my visit and to keep the information confidential.
I understand that I may direct to the Johns Hopkins Privacy Officer any questions I have about my obligations under this Confidentiality Pledge or under any of the Hopkins policies and procedures and applicable laws and regulations related to confidentiality.
The contact information is Johns Hopkins Privacy Officer, telephone: 410-735-6509, e-mail: HIPAA@jhmi.edu.
“The Office of Continuing Medical Education at The Johns Hopkins University School of Medicine, as provider of this activity, has relayed information with the CME attendees/participants and certifies that the visitor is attending for training, education and/or observation purposes only.”
For CME Questions, please contact the CME Office at (410) 955-2959 or e-mail cmenet@jhmi.edu.
For CME Certificates, please call (410) 502-9634.
Johns Hopkins University School of Medicine
Office of Continuing Medical Education
Turner 20/720 Rutland Avenue
Baltimore, Maryland 21205-2195
Reviewed and Approved by
General Counsel, Johns Hopkins Medicine (4/1/03)
Updated 4/09
Hardware & Software Requirements
Pentium 800 processor or greater, Windows 98/NT/2000/XP/7 or Mac OS 9/X, Microsoft Internet Explorer 5.5 or later, 56K or better modem, Windows Media Player 9.0 or later, 128 MB of RAM, sound card and speakers, Adobe Acrobat Reader, storage, Internet connectivity, and minimum connection speed. Monitor settings: High color at 800 x 600 pixels. |
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GUESTS
AUTHORs OF THE MONTH |
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Commentary:
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Mark S. Sulkowski, MD
Associate Professor of Medicine
Divisions of Infectious Diseases and
Gastroenterology/Hepatology
The Johns Hopkins University School of Medicine
Baltimore, Maryland
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Guest
Faculty Disclosures
Mark S. Sulkowski, MD has disclosed that he has received grants/research support from Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., BMS, Gilead, Janssen, Merck, Roche and Vertex Pharmaceuticals. He has also served as a consultant for Abbott, Boehringer Ingelheim Pharmaceuticals, Inc., BMS, Gilead, Janssen, Merck, Novartis, Pfizer, Roche, and Vertex Pharmaceuticals.
Unlabeled/Unapproved Uses
The author has indicated that he will reference the unlabeled/unapproved uses of telaprevir and boceprevir for the treatment of HCV in HIV-infected persons in this presentation.
Program
Directors’ Disclosures |
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TO ACCESS THE
POST-TEST
Step
1.
Review the CE Information and study the educational content.
Step
2.
Click the post-test link at the end of the newsletter.
Step
3.
Follow the instructions to access a post-test.
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