Kris V. Kowdley, MD
Professor of Medicine
University of Washington School of Medicine
Karen Luken, MS, ARNP, FNP-C
Family Nurse Practitioner-Gastroenterology/Hepatology
Overland Park, Kansas
Richard H. Davis Jr., PA-C
Senior Physician Assistant
Department of Medicine
Division of Gastroenterology, Hepatology, and Nutrition
University of Florida
Family Medicine Consultant:
William A. Schwer, MD
Chairman Department of Family Medicine
Rush- Presbyterian-St. Luke’s Medical Center
Physicians, PAs: 1
Nurses, NPs: 1.2 Medium
Podcast (MP3 & PDF)
This version of this title is a Podcast MP3 Audio release.
Chronic hepatitis B virus (HBV) infection is one of the most common infectious diseases worldwide, with an estimated 350 million people infected, including 1.5 million Americans. Although the availability of a vaccine against HBV has led to a reduction in the rate of infection, there is still a large reservoir of chronic HBV carriers who can transmit the disease through personal contact or to their newborn children. The ultimate prognosis for persons with chronic HBV infection is poor. These patients are at increased risk for development of decompensated liver disease, cirrhosis, and hepatocellular carcinoma, which result in approximately 6,000 deaths per year in the US.
The diagnosis of chronic HBV infection is typically made using serologic markers for HBV disease; for example, the presence of HBsAg for > 6 months indicates chronic HBV infection. Other serologic tests used to evaluate patients with chronic HBV include HBeAg, which reflects active viral replication.
There are 5 potent antiviral agents available today to treat HBV infection, and the goal of antiviral treatment is to suppress HBV replication. The challenge to the practitioner is to identify those patients with chronic HBV infection who would benefit from antiviral therapy and to select the most appropriate agent for each patient.
This program will review the epidemiology and natural history of chronic HBV infection and the current guidelines for vaccination against HBV. In addition, attention will be focused on the current serologic methods and virologic testing that are used to make the diagnosis of chronic HBV infection. Finally, the discussion will center on the treatment options available today for patients with chronic HBV infection, as well as the appropriate screening procedures used in the long-term care of these patients. Program Developer/Facilitator
. Target Audience
This educational activity is designed to meet the needs of primary care physicians, nurses, nurse practitioners, and physician assistants with an interest in the epidemiology, diagnosis, and management of chronic hepatitis B virus infection.
Upon completion of this educational activity, the participant should be able to:
Discuss how to identify candidates for treatment among patients with chronic HBV infection and the treatment options that are currently available.
Describe the epidemiology, natural history, and risk factors for chronic hepatitis B virus (HBV) infection.
Review the appropriate use of hepatitis B vaccine in infants and high-risk patients.
Describe the tests used to accurately make the diagnosis of chronic HBV infection, and the appropriate screening procedures for the long-term care of HBV-infected carriers.
AKH Inc. and its shareholders have no significant financial relationships with the manufacturers of medical or pharmaceutical products, nor with the providers of non-educational medical services. It is the policy of AKH Inc. to ensure independence, balance, objectivity, scientific rigor, and integrity in all of their continuing education activities. The faculty must disclose to the participants any significant relationships with the commercial companies whose products or devices may be mentioned in the monograph or with the commercial supporter of this continuing education activity. The information is for participant information only; it is not assumed that these relationships will have a negative impact on the content of the activity.
Kris V. Kowdley, MD discloses that he is a member of speakers bureaus for Gilead, GlaxoSmithKline, Roche Pharmaceuticals, Bristol-Myers Squibb, and Schering-Plough, He is on advisory committees for Gilead and Bristol-Myers Squibb.
Karen Luken, MS, ARNP, FNP-C discloses that she is a member of speakers bureaus for Roche Pharmaceuticals and Schering-Plough.
Richard H. Davis Jr., PA-C discloses that he is on a speakers bureau for Schering-Plough.
William A. Schwer, MD reports that he has no significant financial interest or other relationships with the manufacturer(s) of any commercial product(s) or service(s) discussed in this educational presentation or with the commercial supporter of this activity.
This educational activity may contain discussion of published and/or investigational uses of agents for the treatment of hepatitis B infection. Some uses of these agents may not been approved by the FDA. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
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 AKH Inc. and Medical Communications Media. AKH Inc. is accredited by the ACCME to provide continuing medical education for physicians.
AKH Inc. designates this educational activity for a maximum of 1 category 1 credit towards the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.
This activity has been reviewed and is acceptable for up to 1 Prescribed credit(s) by the American Academy of Family Physicians. AAFP accreditation begins 11/01/05. Term of approval is for one-year(s) from this date, with option for yearly renewal.
This program has been reviewed and is approved for a maximum 1 hour of AAPA Category I (Preapproved) CME credit by the Physician Assistant Review Panel. Approval is valid for one year from the issue date of November 1, 2005. Participants may submit the self-assessment at any time during that period.
This program was planned in accordance with AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs.
AKH Inc. is approved as a provider of nurse practitioner continuing education by the American Academy of Nurse Practitioners. Provider #030803. AKH Inc. designates this educational activity for 1.2 contact hour(s).
AKH Inc. is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. AKH Inc. designates this educational activity for 1.2 contact hours.
Successful completion of the self-assessment is required to earn credit. Successful completion is defined as a cumulative score of at least 70% correct.
Commercial Support Statements
Supported by an educational grant from Bristol-Myers Squibb.
This program consists of a Podcast/MP3 audio file and PDF monograph. You may play the audio on line or download the file to an MP3 audio player such as an Ipod. You will also need Adobe Acrobat Reader to view and print the monograph portion of the program. The activity will require approximately 60 minutes to complete.
Click on the "Start Program" icon.
Save the PDF file to your computer or open the file using the Adobe Acrobat Reader. Print a copy of the monograph, which includes the post-test and program evaluation.
Download or play the audio file by clicking on the appropriate button. Instructions for utilizing this program on a portable MP3 player such as an Ipod can be found on this page.
Refer to the figures and tables in the monograph while listening to the audio.
After reading the monograph and listening to the audio, complete the post-test and evaluation found on the last two pages of the monograph. Mail the pages according to printed instructions. A certificate of credit for satisfactory completion (70% or better) will be mailed within 4 to 6 weeks.
This CME/CE activity is provided free of charge. PAs who are not members of the AAPA and wish to receive AAPA CME credit are required to pay a $20 scoring fee at the time of post-test submission.
None of the contents may be reproduced in any form without prior written permission of the publisher. The opinions expressed in this publication and audio CD are those of the speakers and do not necessarily reflect the opinions or recommendations of their affiliated institutions, the publisher, AKH Inc., or Bristol-Myers Squibb. Any medications, or other diagnostic or treatment procedures discussed by the program speakers should not be utilized by clinicians without evaluation of their patients’ conditions and of possible contraindications or risks, and without a review of any applicable manufacturer’s product information and comparison with the recommendations of other authorities.