CCO Annual Update
Hepatitis Annual Update 2006
Hepatitis B Virus Resistance for Clinicians
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Module 1 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
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 Anna Lok, MD, discusses the development of HBV drug resistance associated with nucleos(t)ide analogue therapy. Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the methods used to detect antiviral-resistant forms of HBV
- Review ways to prevent the development of antiviral-resistant HBV
- Discuss the management of antiviral-resistant HBV
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The Changing Face of Antiviral Therapy in Hepatitis B
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Module 2 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
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Robert Perrillo, MD, discusses current and emerging treatment approaches for HBV infection, highlighting the potential role of long-term antiviral suppression. Learning Objectives
Upon completion of this activity, participants should be able to:
- Review advances with currently licensed antivirals and those in late-stage development
- State the findings of recent studies linking long-term disease complications to hepatitis B virus replication
- Discuss the implications that long-term antiviral suppression could have on the management of hepatitis B virus
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New Agents in Development for Hepatitis B
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Module 3 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
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Patrick Marcellin, MD, PhD, discusses novel therapies for hepatitis B currently in development, some of which have alternative targets in the HBV viral life cycle and may improve virologic response and resistance rates. Learning Objectives
Upon completion of this activity, participants should be able to:
- List the drugs in clinical development for the treatment of hepatitis B, and their potential role in treatment
- Recount the latest clinical trial data on new agents for the treatment of chronic hepatitis B
- Identify drugs in earlier stages of development
- Define strategies for developing new classes of drugs
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Update on the Management of HBV
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Module 4 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
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Marc Ghany, MD, discusses a recent National Institutes of Health (NIH)
Workshop on the management of chronic hepatitis B; experts gathered to assess issues such as current advances in the fundamental comprehension of the hepatitis B virus (HBV) and chronic hepatitis B, optimal management strategies, and viable directions for future research. Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the purpose of the National Institutes of Health (NIH) workshop on management of Hepatitis B
- Review the conclusions of the NIH workshop
- Discuss the unresolved issues and challenges raised by the workshop
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Interferon and Ribavirin: Mechanisms of Action, Resistance, and Why It Matters
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Module 5 of 10
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CME Program Director:
Emmet B. Keeffe, MD, MACP
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Raymond Chung, MD, describes the natural history, structure, and life cycle of HCV, and uses viral kinetic modeling as a framework for conceptualizing interferon’s various mechanisms of action as well as those of other antiviral agents acting through different mechanisms. Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the epidemiology, natural history, and life cycle of hepatitis C virus (HCV)
- Review mechanisms of current approaches for the treatment of HCV
- Recount the rationale and potential for novel agents in the treatment of HCV
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New Therapies for Chronic Hepatitis C
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Module 6 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
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Gary Davis, MD, discusses novel agents currently in development for hepatitis C treatment; in contrast to interferon and ribavirin, these new drugs target critical processes in the HCV life cycle. Learning Objectives
Upon completion of this activity, participants should be able to:
- Discuss prospective therapeutic targets inherent in the mechanism of hepatitis C virus (HCV) viral replication
- Explain the rationale for and potential utility of novel agents under development for the treatment of HCV
- Summarize recent data from clinical trials of investigational new anti-HCV drugs
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Customizing HCV Therapy With Current Agents: Optimizing Patient Outcomes
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Module 7 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
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Mark S. Sulkowski, MD, reviews emerging data supporting the use of viral kinetics to improve individual patient outcomes in the treatment of HCV with peginterferon plus ribavirin. Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe general principles of individualizing therapy based on patient and viral characteristics
- Recount factors or markers that are predictive of HCV treatment success
- Discuss specific strategies for optimizing treatment, such as longer treatment for genotype 1 and shorter treatment for genotype 2/3
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Debate: Are Noninvasive Tests Ready to Replace Liver Biopsy?
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Module 8 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
 
- Nezam H. Afdhal, MD, FRCPI
- Mitchell L. Shiffman, MD
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Nezam Afdhal, MD, and Mitchell Shiffman, MD, debate the pros and cons of various direct and indirect biomarkers that have been developed for monitoring fibrosis vs liver biopsy, their implications for clinical practice, and the potential for their use in place of liver biopsies for assessing a patient’s type and grade of fibrosis. Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the role of liver biopsy and the noninvasive tests available (and in development) for the diagnosis of liver fibrosis and inflammation
- Review the latest data supporting the use of liver biopsy or noninvasive tests, including data on risk, sensitivity, and specificity
- Discuss the limitations of liver biopsy and noninvasive tests
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Liver Transplantation: The Past Quarter Century and the Future
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Module 9 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
- Emmet B. Keeffe, MD, MACP
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Emmet Keeffe, MD, MACP, traces progress in human liver transplantation over the past 25 years, provides a brief summary of the current use of liver transplantation, and speculates on the future directions of liver transplantation. Learning Objectives
Upon completion of this activity, participants should be able to:
- Review the changes in liver transplantation over the past 25 years
- Discuss the impact of different systems for assigning scarce liver to patients with end-stage liver disease or hepatocellular carcinoma
- Describe what the trends in liver disease and transplantation suggest for the future
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The Paradox of Treating Liver Disease With Potentially Hepatotoxic Drugs
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Module 10 of 10
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Program Director:
Emmet B. Keeffe, MD, MACP
 
- Eugene R. Schiff, MD, MACP, FRCP, MACG
- Ronald Concha, MD
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Ronald Concha, MD, and Eugene Schiff, MD, review common examples of potentially hepatotoxic drugs used to treat disorders associated with liver disease. Learning Objectives
Upon completion of this activity, participants should be able to:
- Review the impact of hepatotoxic drugs on the liver
- Discuss the effect of statins, thiazolidinediones, and other lipid-lowering and antiglycemic agents on liver disease
- Describe the impact of acetaminophen on liver disease
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Animations
Life Cycle of Hepatitis C Virus
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Presents the steps by which the hepatitis C virus infects and replicates in the cell.
This animation and others are available for use offline from the Download Library.
To download to your own computer and use for personal or teaching purposes, click here
Format: Adobe Flash | File size: 4,414 KB
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Drug Targets in the Hepatitis C Virus Life Cycle
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Dr. Gary Davis discusses potential targets for new therapeutic agents in the hepatitis C virus life cycle. This animation and others are available for use offline from the Download Library.
This animation and others are available for use offline from the Download Library.
To download to your own computer and use for personal or teaching purposes, click here
Format: Adobe Flash | File size: 19,025 KB
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CCO Slidesets
4th Annual Clinical Care Options for Hepatitis Symposium: HBV Highlights
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Format: Microsoft PowerPoint (.ppt) | File size: 619 KB
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4th Annual Clinical Care Options for Hepatitis Symposium: HCV Highlights
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Format: Microsoft PowerPoint (.ppt) | File size: 2,631 KB
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4th Annual Clinical Care Options for Hepatitis Symposium: Hot Topics
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Format: Microsoft PowerPoint (.ppt) | File size: 424 KB
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Disclaimer: The materials published on the Clinical Care Options Web site reflect the views of the reviewers or authors of the CCO material, not those of Clinical Care Options, LLC, the CME provider, or the companies providing educational grants. The materials may discuss uses and dosages for therapeutic products that have not been approved by the United States Food and Drug Administration. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or using any therapies described in these materials.
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Contact Info
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Educational grants support only the CME-certified components of this program.
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