Addressing the Unique Needs of Military Veterans With Chronic HCV Infection

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CME/CE-Certified Supplement

Activity Information

Original Release Date: February 1, 2017
Expiration Date: February 1, 2018
Estimated Time to Complete Activity: 1.5 hours

Provided by

Supported by an educational grant from
Merck and Company

Target Audience

This journal supplement is intended for gastroenterologists, infectious disease specialists, family practitioners, internists, nurse practitioners, physician assistants, and other clinicians who treat patients with chronic hepatitis C (HCV) infection, including those with end-stage renal disease (ESRD), within the United States Veterans Health Administration (VHA).


Alexander Monto, MD, Chair
Director, Liver Clinic, San Francisco Veterans Affairs Medical Center
Professor of Medicine, San Francisco School of Medicine
University of California
San Francisco, California

Pamela S. Belperio, PharmD, BCPS
National Public Health Clinical Pharmacist
Department of Veterans Affairs
Los Angeles, California
Patient Care Services/Population Health
Veterans Affairs Palo Alto Healthcare System
Palo Alto, California

Hashem B. El-Serag, MD, MPH
Gastroenterology and Hepatology
Michael E. DeBakey Veterans Administration Medical Center
Baylor College of Medicine
Houston, Texas

Rachel Gonzalez, MPH
Health Science Specialist
Program Manager, National Hepatitis C Resource Center
Long Beach, California

Fasiha Kanwal, MD, MSHS
Professor of Medicine, Interim Chief, Gastroenterology and Hepatology
Baylor College of Medicine
Houston Veterans Affairs HSR&D Center of Excellence
Michael E. DeBakey VA Medical Center
Houston, Texas

Timothy Morgan, MD
Chief, Hepatology, VA Long Beach Healthcare System
Long Beach, California

Angela Park, PharmD, CACP
Clinical Pharmacy Specialist
Pharmacy Process Improvement Program Manager
New England Veterans Engineering Resource Center
Boston, Massachusetts

David B. Ross, MD, PhD, MBI
Director of HIV, Hepatitis, and Related Conditions Programs
Department of Veterans Affairs
Washington, DC

Method of Participation

Participants should read the activity information, review the activity in its entirety, and complete the online posttest and evaluation. Upon completing this activity as designed and achieving a passing score on the post-test, you will be directed to a Web page that will allow you to receive your certificate of credit via e-mail or you may print it out at that time.
The online post-test and evaluation can be accessed at:
Inquiries may be directed to Global Academy for Medical Education at or (973) 290-8225.

Accreditation Statements

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 providership of Global Education Group and Global Academy of Medical Education. Global Education Group is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation:
Global Education Group designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Continuing Education
Global Education Group is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
This educational activity for 1.5 contact hours is provided by Global Education Group. Nurses should claim only the credit commensurate with the extent of their participation in the activity.

Educational Needs

The prevalence of chronic HCV infection among patients in the Veterans Health Administration (VHA) is approximately 4 times that of the general population. Approximately 50,000 US military veterans are infected with HCV, but their infection has not been diagnosed. The VHA is uniquely suited to treat HCV infection as well as to address its significant mortality and morbidity. However, infected veterans—as well as the VHA clinicians who manage these patients on a regular basis—face many barriers to diagnosis, testing, and treatment, barriers that in many ways are unlike those encountered in the private sector. To address those barriers, in recent years the VHA has made a substantial commitment to providing HCV care, as reflected in expanded funding, the establishment of Veterans Integrated Service Network–level HCV Resource Centers and Hepatitis C Innovation Teams (HITs), and other steps aimed at providing efficient, effective care. The expanding armamentarium of direct-acting antiviral (DAA) agents for HCV infection means that approximately 95% of treated individuals can experience sustained virologic response—essentially, a cure. Clinicians within the Department of Veterans Affairs (VA) system need education to raise their awareness of screening protocols, the need to evaluate HCV genotypes and the possible presence of resistance-associated polymorphisms, the selection of often complex drug regimens, and the importance of managing comorbidities, including psychiatric illness, substance abuse-related problems, and liver conditions such as cirrhosis and hepatocellular carcinoma.

Learning Objectives

At the conclusion of this program, participants should be better able to:

  • Recognize the special characteristics of the patient population with chronic HCV infection whose care is managed within the US VHA, including risk factors and medical and psychiatric comorbidities
  • Identify opportunities for improving HCV screening, diagnosis, and testing among the veteran population
  • Develop comprehensive individualized management strategies for patients with chronic HCV infection
  • Compare and contrast risks and benefits of currently available drug regimens for treating chronic HCV infection
  • Describe practical approaches for improving the continuum of care for veterans with chronic HCV infection.

Disclosure Declarations

Global Education Group requires instructors, planners, managers, and other individuals and their spouse/life partner 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 Global Education Group for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Alexander Monto, MD, Chair; Dr Monto’s wife has been a consultant for Gilead Sciences, Inc.

Pamela S. Belperio, PharmD, BCPS, has nothing to disclose.

Hashem B. El-Serag, MD, MPH; Grant/Research Support: Gilead and Wako Pure Chemical Industries, Ltd.

Rachel Gonzalez, MPH, has nothing to disclose.

Fasiha Kanwal, MD, MSHS; Grant/Research Support: Gilead.

Timothy Morgan, MD; Grant/Research Support: Abbvie Pharmaceuticals, Inc., Bristol-Myers Squibb Company, Genentech, Gilead, Hoffman-LaRoche, Merck & Co.

Angela Park, PharmD, CACP, has nothing to disclose.

David B. Ross, MD, PhD, MBI,has nothing to disclose.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:
Global Academy for Medical Education Staff: Sylvia H. Reitman, MBA, DipEd; Mike LoPresti; Shirley V. Jones, MBA; Ron Schaumburg; Tom Garry; and Suzanne Bujara hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months.

Global Education Group: The following planners and managers, Ashley Marostica, RN, MSN; Andrea Funk; Laura Gilsdorf, have nothing to disclose.

Global Education Group Contact Information For information about the accreditation of this program, please contact Global Education Group at (303) 395-1782 or

Off-Label/Investigational Use Disclosure
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 planners of this activity do not recommend the use of any agent outside of the labeled indications.

Contact Information for Technical Questions

Please technical questions or concerns to Global Academy for Medical Education at 973-290-8225 or email

Copyright Statement

Copyright © 2017 by Global Academy for Medical Education, LLC, Frontline Medical Communications Inc., and its Licensors. All rights reserved. No part of this publication may be reproduced or transmitted in any form, by any means, without prior written permission of the Publisher. Global Academy for Medical Education, LLC, Global Education Group, and Frontline Medical Communications will not assume responsibility for damages, loss, or claims of any kind arising from or related to the information contained in this publication, including any claims related to the products, drugs, or services mentioned herein.

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