Hepatitis C Prevention, Management and Treatment for Addiction Medicine Practitioners (1.5 CME)
(1.5CME) In this conference recording from the 2018 Annual Conference, you will learn that, globally, hepatitis C virus (HCV) infection is a major health issue among people who inject drugs (PWID). Within 1 year of injecting drugs, 1 of 3 individuals will become infected with HCV. Overall, 70 to 77% of PWID are HCV positive. There is a growing burden of HCV-related cirrhosis, liver cancer, and liver-related mortality, particularly among those infected for many decades. Perhaps even more concerning is the growing number of younger individuals newly infected with HCV through injection opiate use (Zibbell, 2014) (Colvin, 2010).
The advent of simple and well-tolerated oral HCV therapeutic regimens – direct-acting antivirals (DAAs) – with cure >95% has the potential to reverse the rising tide of advanced liver disease and with cure, prevent disease transmission (Grebely, 2017). These effective DAAs have eliminated interferon as a major barrier to HCV scale-up in PWID.
However, in order for these therapies to have an effect at a population-level, targeted interventions to enhance HCV testing, linkage to care, and treatment are needed. The reluctance to offer HCV therapy to PWID often still stems from concerns around treatment adherence, poorer outcomes, and the potential risk for HCV reinfection (Grebely, 2017). This reluctance exists despite growing evidence that HCV can be successfully treated among active drug users (Muething, 2015).
Furthermore, stigma and judgement regarding drug use and addiction among traditional HCV treaters has led to mistrust and reluctance to seek care by providers (Feller, 2013). This workshop will review the epidemiology of HCV among PWID, and effective strategies to enhance HCV testing, linkage to care and treatment for PWID. A particular focus will be given to the role of addiction medicine practitioners in preventing and treating HCV, especially in substance treatment facilities.
Alain H. Litwin
Alain Litwin, MD, MPH is Vice Chair of Academics and Research and Professor of Medicine at Greenville Health System, University of South Carolina School of Medicine – Greenville, and Clemson University School of Health Research where he is launching a Center for Addiction and Prevention Research. He is board certified in internal medicine and addiction medicine, and has been providing medical care to people who use drugs with complex social, psychiatric and medical needs within an integrated primary care and substance use treatment program since 2000. As HCV Medical Director at Albert Einstein’s Division of Substance Abuse, he developed a comprehensive on-site HCV treatment program and peer educator program to improve medical care of HCV-infected people who use drugs. As HCV Treatment Network Director at Montefiore Medical Center, he expanded patient-centered models of care at many community health centers serving thousands of HCV-infected people throughout the Bronx. With funding from NIH, PCORI, CMS, CDC, AHRQ, the Robert Wood Johnson Foundation, New York State Department of Health, New York City Department of Health, and industry, Dr. Litwin’s research has been focused on developing and studying models of HCV care, and on advocating for increasing access to effective care for all HCV-infected patients. Dr. Litwin has worked with government and community organizations on efforts to expand access to HCV treatment and has collaborated on policy statements, clinical guidelines, treatment improvement protocols, task forces, and educational curricula with the New York City Department of Health and Mental Hygiene, New York State Department of Health, Substance Abuse and Mental Health Service Administration, Center for Substance Abuse Treatment, American Association for the Treatment of Opioid Dependence, and the American Society of Addiction Medicine. Dr. Litwin serves on the Executive Board for the International Network on Hepatitis in Substance Users (INHSU).
ACCME Accreditation Statement
The American Society of Addiction Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
AMA Credit Designation Statement
The American Society of Addiction Medicine designates this enduring material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
ABPM Maintenance of Certification (MOC)
The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 1.5 LLSA credits towards ABPM MOC Part II requirements.
ABAM Transitional Maintenance of Certification (tMOC)
This course has been approved by the American Board of Addiction Medicine (ABAM). Physicians enrolled in the ABAM Transitional Maintenance of Certification Program (tMOC) can apply a maximum of 1.5 AMA PRA Category 1 Credit(s)™ for completing this course.