Updates in HCV Screening and Treatment

Jointly provided by Postgraduate Institute for Medicine and Integritas Communications This activity is supported by an independent educational grant from Gilead Sciences, Inc. This event is neither sponsored nor endorsed by the American College of Obstetricians and Gynecologists.

MEDICAL COMMUNICATIONS INQUIRIES info@integritasgrp.com integritasgrp.com

Nancy S. Reau, MD

FACULTY

FACULTY

The Richard B. Capps Chair of Hepatology Professor, Department of Internal Medicine Division of Digestive Diseases and Nutrition Rush Medical College Chief, Section of Hepatology Associate Director of Organ Transplantation Rush University Medical Center Chicago, Illinois Dr. Nancy Reau is Professor of Internal Medicine, Associate Director of Organ Transplantation, and Section Chief of Hepatology at Rush University Medical Center in Chicago, Illinois. She received her medical degree from The Ohio State University College of Medicine in Columbus, where she completed a residency and fellowship in gastroenterology/hepatology followed by a second fellowship in advanced transplant hepatology at Johns Hopkins Hospital in Baltimore, Maryland. Her primary research interests focus on viral hepatitis from both a drug development and a clinical perspective, liver transplantation, and complications of chronic liver disease.

Dr. Reau has been an invited lecturer at numerous presentations focused on viral hepatitis, fatty liver disease, cirrhosis, and liver transplantation. A fellow of the American Gastroenterological Association and the American Association for the Study of Liver Diseases (AASLD), she is the current editorin-chief of Clinical Liver Disease and was an author of the AASLD/Infectious Diseases Society of America (IDSA) hepatitis C guidance document. She was chair of the AASLD public policy committee and a member of the AASLD practice guideline committee for 4 years.

Dr. Reau has authored or coauthored more than 100 peer-reviewed articles that have been published in journals such as Hepatology, Hepatitis Research and Treatment, and Clinics in Liver Disease. She is co-chair of the National American Liver Foundation’s Medical Advisory Committee and sits on multiple advisory boards. Currently a member of the steering committee for the hepatitis C special interest group (SIG) of the AASLD, she is also a member of the American College of Gastroenterology training committee.

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Joanne L. Stone, MD, MSHCDL FACULTY

Director, Maternal Fetal Medicine Mount Sinai Health System Fellowship Director, Maternal Fetal Medicine Mount Sinai Hospital Professor, Obstetrics, Gynecology and Reproductive Sciences Icahn School of Medicine at Mount Sinai New York, New York

Dr. Joanne Stone is a well-known expert in the field of maternal-fetal medicine and serves as the Maternal Fetal Medicine (MFM) Division Director for the Mount Sinai Health System and as the MFM Fellowship Director and Vice Chair for Diversity and Inclusion in her department. She completed her residency and fellowship at the Icahn School of Medicine at Mount Sinai and stayed on as full-time faculty. Dr. Stone is also on the executive committees of the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists.

Dr. Stone’s clinical interests are in multiple gestations, prenatal diagnosis, and invasive fetal procedures. Her research interests span the gamut of multifetal pregnancies, labor induction, and ultrasound. She has a busy consultative and clinical practice, as well as being active in teaching and research. Co-author of the books Pregnancy for Dummies and The Pregnancy Bible, Dr. Stone has been named a Castle-Connolly/New York Magazine Top Doctor and listed as a Super Doctor by The New York Times Magazine for the past several years.

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TARGET AUDIENCE

This educational activity is intended to educate obstetrics/gynecology (OB/GYN) physicians, physician assistants, nurse practitioners, and nurse midwives on appropriate hepatitis C virus (HCV) screening, testing, and referral practices for their patients.

Upon completion of this activity, participants will be better able to: • Provide proactive HCV screening and confirmatory testing or OB/GYN patients per guidelines from the American Association for the Study of Liver Diseases and the Society for Maternal-Fetal Medicine • Counsel patients on the implications of HCV infection, efficacy and safety of current direct-acting antiviral treatment regimens for chronic HCV infection, and behavioral risk reduction • Coordinate appropriate referrals and multidisciplinary care for HCV-infected women presenting in OB/GYN practices

PROGRAM OVERVIEW

This educational session is designed to better prepare OB/GYNs to identify patients who should be screened for HCV based on relevant professional society recommendations, appropriately link patients to care, and manage pregnancies of women who have HCV. Expert faculty will provide practical information on HCV screening, confirmatory testing, patient education, and counseling strategies for use within the real-world clinical context of OB/GYN practice. Although HCV affects women across diverse age groups and demographics, pregnancy raises additional considerations and risks for the HCV-infected mother and her unborn child, including mother-to-childtransmission of the virus, for which faculty will share recommendations and management insights.

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PREAMBLE

EDUCATIONAL OBJECTIVES

JOINT ACCREDITATION STATEMENT

PREAMBLE

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.

PHYSICIAN CONTINUING MEDICAL EDUCATION The Postgraduate Institute for Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit ™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

CONTINUING NURSING EDUCATION

The maximum number of hours awarded for this Continuing Nursing Education activity is 1.0 contact hour. Pharmacotherapy contact hours for Advanced Practice Registered Nurses to be determined.

INSTRUCTIONS TO RECEIVE CREDIT

A statement of credit will be issued only upon receipt of a completed activity evaluation form and will be emailed to you within 3 weeks. You will receive your certificate from CEcertificate@pimed.com. If you have questions regarding the receipt of your emailed certificate, please contact Postgraduate Institute for Medicine (PIM) via email at inquiries@pimed.com.

DISCLOSURE OF CONFLICTS OF INTEREST The Postgraduate Institute for Medicine requires instructors, planners, managers, and other individuals and their spouses/life partners who are in a position to control the content of this activity to disclose any real or apparent conflicts of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by the Postgraduate Institute for Medicine for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

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The faculty reported the following financial relationships or relationships to products or devices they or their spouses/life partners have with commercial interests related to the content of this CME activity: Nancy S. Reau, MD Consulting Fees: AbbVie Inc., Gilead Sciences, Inc., Intercept Pharmaceuticals, Inc., Merck & Co., Inc; Contracted Research: GENFIT SA, Intercept Pharmaceuticals, Inc., Shire plc Joanne L. Stone, MD, MSHCDL No financial relationships to disclose

PREAMBLE

The PIM planners and managers have nothing to disclose. The Integritas Communications planners and managers have nothing to disclose.

DISCLOSURE OF UNLABELED USE

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. The Postgraduate Institute for Medicine and Integritas Communications 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 any organization associated with this activity. 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 in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

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CLINICAL PRACTICE GUIDELINES »»Testing Recommendations for Hepatitis C Virus Infection

Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/hcv/guidelinesc.htm

»»A Guide to Comprehensive Hepatitis C Counseling and Testing.

Centers for Disease Control and Prevention. https://www.cdc.gov/hepatitis/resources/professionals/pdfs/ counselingandtestingpc.pdf

»»HCV Guidance: Recommendations for Testing, Managing, and Treating Hepatitis C. American Association for the Study of Liver Diseases/Infectious Diseases Society of America, 2017. https://www.hcvguidelines.org/

»»Hepatitis C in Pregnancy: Screening, Treatment, and Management.

Society for Maternal-Fetal Medicine https://www.ajog.org/article/S0002-9378(17)30930-4/fulltext

»»Hepatitis B and Hepatitis C in Pregnancy.

»»Hepatitis C: Screening.

U.S. Preventive Services Task Force, 2013. https://www.uspreventiveservicestaskforce.org/Page/Document/ RecommendationStatementFinal/hepatitis-c-screening

»»Viral Hepatitis Surveillance — United States, 2015.

Centers for Disease Control and Prevention, 2015. https://www.cdc.gov/hepatitis/statistics/2015surveillance/ pdfs/2015HepSurveillanceRpt.pdf

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RESOURCE CENTER

The American College of Obstetricians and Gynecologists https://www.acog.org/Patients/FAQs/Hepatitis-B-and-HepatitisC-in-Pregnancy

PATIENT RESOURCES »»Centers for Disease Control and Prevention Fact sheets for patients. https://www.cdc.gov/hepatitis/hcv/patienteduhcv.htm

»»Hepatitis C and Injection Drug Use. This webpage provides concise information regarding HCV risk, transmission, and prevention in people who inject drugs. https://www.cdc.gov/hepatitis/hcv/pdfs/factsheet-pwid.pdf

SUGGESTED READING »»Vertical transmission of hepatitis C: towards universal antenatal screening in the era of new direct acting antivirals (DAAs)? Short review and analysis of the situation in Switzerland.

Aebi-Popp K, et al. J Virus Erad. 2016;2(1):52-54. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946698/

»»Premature ovarian senescence and a high miscarriage rate impair fertility in women with HCV. Karampatou A, et al. J Hepatol. 2018;68(1):33-41. https://www.journal-of-hepatology.eu/article/S0168-8278(17)32259-6/fulltext

RESOURCE CENTER

»»Medical and behavioral approaches to engage people who inject drugs into care for hepatitis C virus infection.

Gonzalez SA, et al. Addict Disord Their Treat. 2017;16(2 suppl 1):S1-S23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5491232/

»»National Viral Hepatitis Action Plan 2017–2020.

U.S. Department of Health and Human Services, 2017. https://www.hhs.gov/hepatitis/viral-hepatitis-action-plan/index.html

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»»The HCV care continuum does not end with cure: a call to arms for the prevention of reinfection.

Falade-Nwulia O, Sulkowski M. J Hepatol. 2017;66(2):267-269. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5472097/

»»Treatment of HCV in persons who inject drugs: treatment as prevention.

RESOURCE CENTER

Grebely J, Dore GJ. Clin Liver Dis. 2017;9(4):77-80. https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/cld.626

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Please visit the CLINICAL RESOURCE CENTER for additional information and resources

www.ExchangeCME.com/ HCVNYC2018RESOURCES

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