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Challenging Cases in HIV:
Identifying and Treating Patients
with Hepatic Coinfections



Jointly Sponsored by:

This activity is supported by an educational grant from Schering-Plough
  The introduction of antiretroviral therapy and highly active antiretroviral therapy (HAART) to restore immunity has significantly improved the prognosis and life expectancy of patients with HIV. Whereas the incidence of opportunistic infections has gradually declined in the HIV/AIDS population, that of liver disease has increased significantly. One third of patients infected with HIV also are infected with hepatitis C (HCV), and their risk for becoming chronically infected with hepatitis B (HBV) has risen to 50%. Furthermore, multiple infections of single/dual (HBV / HCV and hepatitis D virus (HDV) / HCV) and triple–viral- hepatitis (HBV / HCV / HDV) are being reported.

Until recently, the mainstay of treatment has been to test for and treat HIV; coinfection status rarely was considered. It is now clear that infectious disease clinicians need to treat and manage liver diseases within the context of coinfection. There have been tremendous advances in the treatment of liver disease in patients who are HIV positive,particularly patients who also are infected with HCV and HBV. This educational program will focus on how clinicians can effectively implement recent advances in diagnostic and therapeutic options for patients with HIV and hepatic coinfections (HCV and HBV).
  Kenneth Sherman, MD
Program Chair
Gould Professor of Clinical Medicine
Division Director
University of Cincinnati School of Medicine
Barbara H. McGovern, MD
Assistant Professor of Medicine
Tufts University School of Medicine
Division of Infectious Diseases
New England Medical Center
Lemuel Shattuck Hospital
  After completing this activity, the participant should be better able to:
• Describe the epidemiology and disease burden of hepatic infections in patients with HIV/AIDS
• Recognize the benefits of aggressively treating liver diseases in patients with HIV/AIDS
• List advances in the treatment of patients coinfected with HIV and HBV or HCV
• Explain how liver infection affects HIV treatment
• Discuss hepatotoxicity and lipid abnormalities associated with HAART
• List approaches to preventing hepatic infections in patients with HIV/AIDS
  • Welcome and Introduction (5 min)
  • Understanding Hepatitis B Coinfection: Case-based Discussion (20 min)
  • Understanding Hepatitis C Coinfection: Case-based Discussion (20 min)
  • Hepatotoxicity (20 min)
  • Question & Answer Session (20 min)
  • Closing Remarks (5 min)
  Target Audience: This activity has been designed to meet the educational needs of HIV physicians, hepatologists, gastroenterologists, infectious disease specialists, primary care physicians, internal medicine physicians, fellows/residents, physician assistants, pharmacists, and nurses involved in the care of patients with HIV.

Physician Continuing Medical Education

Accreditation Statement: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Advanced Studies in Medicine (ASiM). PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation: Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Pharmacist Continuing Education

Accreditation Statement: Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Credit Designation: Postgraduate Institute for Medicine (PIM) designates this continuing education activity for 1.5 contact hour(s) (0.15 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Program Number – 809-999-07-008-L02)

Nursing Continuing Education

Purpose: Provide the latest information on how clinicians can effectively implement recent advances in diagnostic and therapeutic options for HIV patients with hepatic coinfections.

CNA/ANCC: This educational activity for 1.5 contact hours is provided by Postgraduate Institute for Medicine (PIM). PIM is an approved provider of continuing nursing education by the Colorado Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

California Board of Registered Nursing: Postgraduate Institute for Medicine is approved by the California Board of Registered Nursing, Provider Number 13485 for 1.5 contact hours.

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 they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

Fee Information: There is no fee for this educational activity.
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