Fundamentals of Liver Disease - Hepatitis B 2.0

5 (9 votes)

Recorded On: 10/15/2020

DESCRIPTION
There is currently an anticipated shortage of trained providers capable of diagnosing and treating different liver diseases. As a result of this increased demand and limited specialists in the field, more and more front-line providers are faced with these patients and do not have the experience or resources that will allow them to manage them appropriately.

The overall goal is to improve patient care by increasing learner competence and confidence in both proper patient identification and assessment and increasing learner performance in therapeutic options and on-treatment management strategies for patients. Patient outcomes will be improved as a result of the improvements in more providers understanding these key components in the management and care of patients with liver diseases.

Key topic areas:

HBV: Epidemiology and Screening
Patient with Positive Hepatitis B Serologies
Natural History of HBV and Identification of Treatment Candidates
Management of the Chronic HBV Patient with Co-morbid and Other Conditions
Antiviral Treatment of the Patient with Chronic HBV
Prevention of HBV Infection
Hepatitis B in the Pediatric Patient

Release date: October 15, 2020
Expiration date: October 14, 2023
Time to complete each module: 30 minutes

CREDITS OFFERED

Continuing Medical Education (CME): For a maximum of 3.50 AMA PRA Category 1 Credits™   
Continuing Education (CE): For a maximum of 3.50 Contact Hour 
You may only earn one Continuing Education Credit type- either CE or CME

Maintenance of Certification (MOC): For a maximum of 3.50 MOC Points


COMPONENTS
Online presentations comprised of PowerPoint slides and accompanying audio, online pre- and post-tests and evaluations:

-7 online interactive, narrated modules 20 to 30 minutes in length
-Pre- and post-test questions for each module
-Evaluation for CME or CE credit offering 

DIRECTIONS
Click "Activate" to register for the enduring material. Review all section tabs before you begin. Select module of interest. Complete all components to claim either CME or CE. MOC is available for learners who complete and earn CME.

COPYRIGHT 
All faculty in this activity have given their permission for publication ©2020 AASLD. 

CONTACT INFORMATION 
For questions on CME and MOC content or LiverLearning®, contact online_education@aasld.org 
For questions on CE credit for this enduring material, contact Certificate@AmedcoEmail.com

Learning Objectives:
• Identify patients with liver disease
• Apply diagnostic tests appropriately
• Discuss important counseling
• Recognize treatment/referral priorities
• Identify first line therapies for different liver diseases
• Refer to specialist in a timely and appropriate fashion

This curriculum was developed for Primary Care Providers and any other healthcare provider interested in liver disease.

Hepatologists
Gastroenterologists
Nurses
Nurse Practitioners
Pharmacists
Physician Assistants
Transplant Coordinators
Surgeons
Fellows/Trainees
Primary Care Physicians
Other healthcare providers

CREDITS OFFERED 
Continuing Medical Education (CME): For a maximum of 3.50 AMA PRA Category 1 Credits™ 
Maintenance of Certification (MOC): For a maximum of 3.50 MOC Points
Continuing Education (CE): For a maximum of 3.50 Contact Hours

ACCREDITATION AND DESIGNATION STATEMENTS Continuing Medical Education (CME) 
The American Association for the Study of Liver Diseases (AASLD) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. AASLD designates this enduring activity for a maximum of 3.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Maintenance of Certification (MOC) 
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 3.50 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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Continuing Education (Nursing Contact Hours)  
In support of improving patient care, this activity has been planned and implemented by Amedco LLC and the American Association for the Study of Liver Diseases.  Amedco LLC 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 healthcare team. Credit Designation Statement – Amedco LLC designates this enduring material activity for a maximum of 3.50 contact hours for nurses. Learners should claim only the credit commensurate with the extent of their participation in the activity.

CLAIMING CME CREDITS 
Physicians and other health care professionals for a maximum of 3.50 AMA PRA Category 1 Credits™ for this enduring continuing medical education material must completed by October 14, 2023

CLAIMING CE CREDITS
Nurses for a maximum of 3.50 contact hours for this enduring continuing education material must be completed by October 14, 2023

CLAIMING ABIM MOC POINTS  
Physicians seeking ABIM MOC credit must complete the enduring material by October 14, 2023. Requests for MOC after this date will not be honored. MOC Points will be reported to the ABIM by the end of each month through October 2023 for individuals who successfully complete MOC.

HOW TO EARN AND CLAIM MOC POINTS For each module that you wish to claim MOC points for you must:

             o    Complete the pre-tests

             o    Watch video presentations

             o    Complete the post-tests and pass with a score of 70% or higher (Participants have unlimited attempts to earn the passing score.)

             o    Claim CME credits (ABIM Rule: MOC points must be equivalent to the amount of CME credits claimed for the activity.)

MOC completions are collected on the 15th of each month and submitted to the ABIM by the last day of the month. Points are not submitted automatically and will not display immediately on your ABIM MOC Profile.

MOC points are available for ABIM board certified physicians only.

Marc G. Ghany

Marc G. Ghany, MD, MHSc, FAASLD is an Investigator at the Liver Diseases Branch of the National Institute of Diabetes and Digestive and Kidney Diseases, and at Warren Grant Magnuson Clinical Center, National Institutes of Health, Bethesda. He is member the Physician Consortium for Practice Improvement for Hepatitis C, which is jointly sponsored by the American Medical Association and AASLD and serves on the hepatitis C Guidance panel which is jointly sponsored by the AASLD and Infectious Diseases Society of America. His work has been honored with the Regal Award for Excellence in Gastrointestinal and Liver Disease and with several NIDDK service awards including the Director’s Award. He received his M.B. and B.Ch. from the Royal College of Surgeon’s, Dublin, and Master of Health Sciences in Clinical Research, Duke University. He completed residency at the Hospital of Saint Raphael, New Haven, Connecticut, a fellowship in gastroenterology at Tulane University, New Orleans, and a clinical fellowship at the Liver Diseases Section, NIDDK. Dr. Ghany’s focus is on translational research to improve the care and treatment outcomes of patients with chronic viral hepatitis. 

 

Tram T. Tran

Tram T. Tran, MD, FAASLD is the Medical Director of Liver Transplantation at Cedars-Sinai Medical Center and Professor of Medicine at Geffen UCLA School of Medicine. Dr. Tran has broad research interests in the areas of viral hepatitis B and C, liver disease in pregnancy and liver transplantation. She is an internationally recognized expert and NIH-funded researcher in the field of chronic hepatitis B, and is active in patient and community advocacy on hepatitis B prevention and treatment. She has authored and co-authored numerous abstracts, papers and chapters in these fields and published in journals.

Norah A. Terrault

Norah A. Terrault, MD, MPH, FAASLD is a Professor of Medicine and Chief of Gastroenterology and Liver Diseases at the Keck School of Medicine at University of Southern California. She received her MD from the University of Alberta and completed fellowships in Internal Medicine and Gastroenterology at the University of Toronto and a master’s in public health at the University of California at Berkeley. 

Dr. Terrault has focused her clinical and research activities on viral hepatitis and non-alcoholic fatty liver disease, especially in special populations including those with cirrhosis and those with transplants. In addition to multiple clinical trials related to preventing and treating chronic hepatitis viral hepatitis and fatty liver, Dr. Terrault has been PI on multiple NIH-funded studies, including the current NIH-supported HBV clinical research network (HBRN) and nonalcoholic steatohepatitis clinical research network (NASH CRN). She has authored 330 peer-reviewed manuscripts, editorials, invited reviews as well as US national guidelines for treatment of chronic hepatitis B and C. She is past associate editor for Hepatology and deputy editor for Liver Transplantation and co-edited Zakim and Boyer’s textbook in hepatology. 

Dr. Terrault is the founder of ECHO-Plus, a multifaceted program to train and support primary care physicians in California to care for patients with hepatitis. She has a long history of mentoring fellows and junior faculty in clinical research and is passionate about creating research support and opportunities for the next generation of GI/Hepatology investigators. Dr. Terrault was recently elected as Councilor to the AASLD governing board and will serve as president in 2023.

Marion G. Peters

Marion G. Peters, MBBS, MD, FAASLD is an Emeritus Professor of Medicine at the University of California at San Francisco and Adjunct Professor of Medicine at Northwestern University, Chicago. She is a hepatologist with a particular interest in viral hepatitis in complicated clinical settings, patients with co-morbid conditions including alcoholism and HIV infection.  She led the NIH AIDS Clinical Trials Group (ACTG) Hepatitis Transformative Science Group (TSG) for 4 years where she championed young investigators to be chairs of new trials in Hep TSG. She is the Protocol Facilitator for ACTG Hepatitis TSG HBV-related studies, focusing on the development of US and international studies for new drugs for patients with HBV, with and without HIV. She is currently a team member or co-chair of 4 ACTG hepatitis trials. She is also a member of the HEP TSG steering committee.

Dr. Peters serves on the scientific Advisory Board of International Antiviral Society USA, HEP DART and is a senior advisor to International Coalition to Eliminate HBV. She is an editor for the Journal of Antimicrobial Chemotherapy. She has trained fellows, house staff and medical students in clinical and translational research, many of whom have gone on to faculty positions focusing on liver disease. She has mentored faculty and fellows in her institution, nationally and internationally. She is particularly focused on mentoring women in medicine.  She has numerous publications on viral hepatitis with and without HIV coinfection in peer-reviewed journals with multiple collaborators.




Anna S. Lok

Anna S. Lok, MD, FAASLD graduated from the University of Hong Kong Medical School. She completed her hepatology training in London under Dame Sheila Sherlock.  She joined the University of Michigan in 1995 as Director of the Hepatology Program. She became Associate Chair for Clinical Research in the Department of Internal Medicine in 2008 and Assistant Dean for Clinical Research in 2016. 

Dr. Lok’s research focuses on natural history and treatment of hepatitis B and C. She has published more than 550 papers on viral hepatitis and liver diseases including the American Association for the Study of Liver Diseases (AASLD) guidelines on “Hepatitis B”. She also participated in the development of the first World Health Organization guidelines on hepatitis B and C. Dr. Lok has made important contributions to the understanding of factors influencing the progression of hepatitis B and C, and the development of new treatments of these diseases. 

Dr. Lok received many awards throughout her career including the Distinguished Scientist Award from the Hepatitis B Foundation in 2008, the Distinguished Service Award from the AASLD in 2011, the William Beaumont Prize in Gastroenterology from the American Gastroenterological Association in 2016, a Gold Medal Award from the Canadian Association for the Study of the Liver and an Hon DSc from the University of Hong Kong in 2017, an International Recognition Award from the European Association for the Study of the Liver in 2018, and a Distinguished University Professorship from the University of Michigan in 2019. 

Dr. Lok served as Associate Editor of HEPATOLOGY in 2002-6, co-Editor of Journal of Viral Hepatitis in 2007-9, Senior Associate Editor of GASTROENTEROLOGY in 2011-2012, and President of AASLD in 2017. 

Brian McMahon

Brian J. McMahon MD, FAASLD is Director of the Liver Disease and Hepatitis Program at the Alaska Native Medical Center (ANMC) in Anchorage, Alaska. Dr. McMahon has served as co-author of the AASLD Practice Guideline for Hepatitis B between 2009 and 2018 and is co-Author of the AASLD Hepatitis B Guidance 2019. He was also the co-chair of the WHO Hepatitis Guideline published in 2015. He directed a program that halted transmission of hepatitis B in the Alaska Native population in the 1980’s, the only US born population endemic for persons with chronic hepatitis B. He oversees the management and care of over 1,000 Alaska Native persons with chronic hepatitis B.

Dr. McMahon has served on the editorial board of Hepatology. He was previously chair of the AASLD Practice Guidelines Committee, was on the AASLD Nominating Committee and was previously chair of the Hepatitis B SIG. He received the AASLD distinguished Mentor/Clinician Award for 2017 for contributions in the global elimination of hepatitis B. He has received multiple NIH and CDC research grants and directs a team of investigators in Alaska. He conducts research in Alaska Native People including hepatitis A and B vaccine long-term efficacy, hepatitis B and C outcome, autoimmune liver diseases and NAFLD. He also has been involved in two hepatitis B projects funded by the Global AIDS program and the CDC Foundation in Tanzania and Zanzibar Africa. He teaches medical students at the University of Alaska/University of Washington WWAMI program, precepts medical students, residents in hepatology clinic and mentors medical students’ research projects. He holds a position as a Research Associate at the Arctic Investigations Program of the CDC located on the ANMC campus in Anchorage. He is Clinical Professor of Medicine at the University of Washington, School of Medicine in Seattle and Auxiliary Professor of Health Sciences at the University of Alaska, Anchorage. He has published over 160 peer review original articles plus over 50 review articles, guidelines/guidance statements and editorials.

Maureen M. Jonas

Maureen M. Jonas, MD, FAASLD is the Director of the Center for Childhood Liver Disease in the Division of Gastroenterology, Hepatology and Nutrition at Boston Children’s Hospital, and Professor of Pediatrics at Harvard Medical School.  Her area of expertise is Pediatric Hepatology and Liver Transplantation, with a special emphasis on viral hepatitis in children. She is the author of a number studies of therapies for pediatric viral hepatitis.

Dr. Jonas has served on several AASLD committees, including the Practice Guidelines Committee, Ethics Committee and Nominating Committee.  She chaired several symposia sponsored by AASLD and the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition at AASLD annual meetings.  She has served as abstract reviewer for AASLD meetings, and ad hoc reviewer for Hepatology.  Jonas established the Pediatric Transplant Hepatology training Program at Boston Children’s Hospital and served as its director until 2016.  She was the Medical Director of the Liver Transplant Service at BCH from 1991 through 2014. As an active educator, she has mentored numerous pediatric gastroenterology and hepatology fellows, as well as junior faculty, over the last 30 years.  She currently serves on the Transplant Hepatology Examination Committee for the American Board of Pediatrics.  She has been the lead Principal Investigator for many multinational pediatric viral hepatitis trials and has lectured extensively on this topic around the country and around the world.

DISCLOSURE OF CONFLICTS OF INTEREST 
AASLD requires all individuals who are in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. Disclosures are collected prior to the start of the educational activity. Any potential conflicts of interest that exist are resolved prior to implementation of the activity. All disclosures are made available and communicated to the leaner prior the activity beginning.

The enduring material organizers, faculty, reviewers and staff have reported the following disclosures:

Marc G. Ghany, MD, MHSc, FAASLD
Faculty
Nothing to disclose

Tram T. Tran, MD, FAASLD
Faculty
Employment: Gilead Sciences (Unrelated)

Norah Terrault, MD, MPH, FAASLD
Faculty
Grant/Research Support: Gilead Sciences and Roche/Genetech

Marion G. Peters, MD, FAASLD
Faculty
Faculty/Advisory Committee or Review Panels: Antios, Atea and Aligos
Employment (Spouse): Genentech Research and Development (subsidiary of Roche)

Anna S.F. Lok, MD, FAASLD
Faculty
Advisory Board: CLEAR-B, Gilead Sciences, GlaxoSmithKline, Huahui, Roche, Spring Bank, and TARGET PharmaSolutions
Grant/Research Support: Assembly Biosciences, Bristol Myers Squibb, Gilead Sciences, and TARGET PharmaSolutions (to University of Michigan)

Brian J. McMahon, MD, FAASLD
Faculty
Grant/Research Support: Gilead Sciences - Grant received by department at institution and not directly.

Maureen M. Jonas, MD, FAASLD
Faculty/Advisory Committee or Review Panels: Served as chair of DSMB for Gilead Sciences
Grant/Research Support: AbbVie, Gilead Sciences, Roche and Merck. Echosens (equipment only)

Lauren A. Beste, MD 
Fundamentals of Liver Disease Committee/Organizer/Reviewer 
Nothing to disclose 

Amanda J. Chaney, DNP, APRN, FNP-BC 
Fundamentals of Liver Disease Committee/Organizer/Reviewer 
Royalities: Springer Publishing-Author 

Leslie Hayes, MD 
Fundamentals of Liver Disease Committee/Organizer/Reviewer 
Nothing to disclose 

Vicki Shah, PA 
Fundamentals of Liver Disease Committee/Organizer/Reviewer 
Scientific Consultant/Advisory to Industry or Commercial Enterprise, including Development of educational Presentations: Gilead, Intercept, AbbVie Advisory Board, Gilead Advisory Board 

Raj Vuppalanchi, MD, FAASLD 
Fundamentals of Liver Disease Committee/Organizer/Reviewer 
Data Safety Monitoring Board for Industry or Commercial Enterprise: Enanta, Enyio and LabCorp/Covance Served as PI for multicenter clinical trials: Intercept, Gilead, Zydus Discovery, Novo Nordisk and Eli Lilly

Dominique Clayton 
AASLD Staff
Nothing to disclose

Denise Seise 
AASLD Staff 
Nothing to disclose

Sheryl Morgan 
Amedco LLC Staff 
Nothing to disclose

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of AASLD. 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 or suggested in this activity should not be used by clinicians without evaluation of their patients' conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Acknowledgement of Commercial Support:
No commercial support was received for this enduring material activity.


Key:

Complete
Failed
Available
Locked
Module 1: HBV: Epidemiology and Screening
Module 1 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 1: HBV: Epidemiology and Screening
Open to view video.
Open to view video. Marc G. Ghany, MD, MHSc, FAASLD
Module 1 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 2: Patient with Positive Hepatitis B Serologies
Module 2 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 2: Patient with Positive Hepatitis B Serologies
Open to view video.
Open to view video. Tram T. Tran, MD, FAASLD
Module 2 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 3: Natural History of HBV and Identification of Treatment Candidates
Module 3 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 3: Natural History of HBV and Identification of Treatment Candidates
Open to view video.
Open to view video. Norah Terrault, MD, MPH, FAASLD
Module 3 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 4: Management of the Chronic HBV Patient with Co-Morbid and Other Conditions
Module 4 Pre-Test
4 Questions  |  1 attempt  |  0/4 points to pass
4 Questions  |  1 attempt  |  0/4 points to pass
Module 4: Management of the Chronic HBV Patient with Co-Morbid and Other Conditions
Open to view video.
Open to view video. Marion G. Peters, MD, FAASLD
Module 4 Post-Test
4 Questions  |  Unlimited attempts  |  3/4 points to pass
4 Questions  |  Unlimited attempts  |  3/4 points to pass
Module 5: Antiviral Treatment of the Patient with Chronic HBV
Module 5 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 5: Antiviral Treatment of the Patient with Chronic HBV
Open to view video.
Open to view video. Anna S.F. Lok, MD, FAASLD
Module 5 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Module 6: Prevention of HBV Infection
Module 6 Pre-Test
4 Questions  |  1 attempt  |  0/4 points to pass
4 Questions  |  1 attempt  |  0/4 points to pass
Module 6: Prevention of HBV Infection
Open to view video.
Open to view video. Brian J. McMahon, MD, FAASLD
Module 6 Post-Test
4 Questions  |  Unlimited attempts  |  3/4 points to pass
4 Questions  |  Unlimited attempts  |  3/4 points to pass
Module 7: Hepatitis B in the Pediatric Patient
Module 7 Pre-Test
5 Questions  |  1 attempt  |  0/5 points to pass
5 Questions  |  1 attempt  |  0/5 points to pass
Module 7: Hepatitis B in the Pediatric Patient
Open to view video.
Open to view video. Maureen M. Jonas, MD, FAASLD
Module 7 Post-Test
5 Questions  |  Unlimited attempts  |  3/5 points to pass
5 Questions  |  Unlimited attempts  |  3/5 points to pass
Final Evaluation
Evaluation (Complete to claim CE or CME credit)
7 Questions
7 Questions Please complete the following evaluation form to share your feedback on this activity.
Claim your continuing education credit
Up to 3.50 medical credits available  |  Certificate available
Up to 3.50 medical credits available  |  Certificate available
Acknowledgement of MOC Submission
Please review and agree to the terms to continue.
Please review and agree to the terms to continue.
MOC Points
Up to 3.50 medical credits available  |  Certificate available
Up to 3.50 medical credits available  |  Certificate available