CCO Management Series
Advanced Topics in Hepatitis C Management: Tools for Nurse Practitioners and Physician Assistants
Retreatment Strategies for Patients Failing First-Line Therapy |
Module 1 of 2 |
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CME Program Director: Michael W. Fried, MD

- HoChong Gilles, RN, MS, FNP
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HoChong Gilles, RN, MS, FNP, reviews clinical management options for patients with chronic HCV infection who fail interferon-based therapy.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Identify causes of nonresponse and relapse to hepatitis C virus (HCV) therapy
- Describe definitions of response during HCV therapy and key time points for monitoring response to treatment
- Discuss diagnosis and management of common adverse effects of HCV therapy and strategies for monitoring patient adherence
- Recall strategies for selecting optimal treatment for patients based on their baseline factors and previous course of therapy
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Overcoming Barriers to Treatment Success in HCV Therapy |
Module 2 of 2 |
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CME Program Director: Michael W. Fried, MD

- Ruth J. Corbett, MSN, ARNP, CCRC
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Ruth J. Corbett, MSN, ARNP, CCRC, discusses challenging scenarios in patients with hepatitis C and strategies for overcoming treatment barriers.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Summarize the key obstacles for treatment success in patients initiating HCV therapy including substance abuse, psychiatric disorders, insulin resistance, and fatty liver disease
- Discuss strategies for assessing and screening patients for treatment barriers prior to initiating HCV therapy
- Describe the pretreatment and on-treatment management of barriers to HCV therapy
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Interactive Case Challenges
Management of a 56-Year-Old Overweight Hispanic Man With Ribavirin Noncompliance and Lack of SVR on Previous Therapy
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CME Program Director: Michael W. Fried, MD
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Scott Moon, PA-C, MMSc, reviews steps for evaluating causes of nonresponse and strategies for optimizing future therapy.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe strategies for determining duration of therapy by on-treatment response in HCV genotype 1–infected patients
- Discuss the importance of maintenance of ribavirin dosage and management of anemia during HCV therapy
- Recount data regarding racial differences in response to HCV therapy
- Describe the impact of insulin resistance and obesity on response to HCV therapy
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Management of a 56-Year-Old Hepatitis C Patient Who Recently Graduated From a 6-Month Resident Drug and Alcohol Treatment Program
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CME Program Director: Michael W. Fried, MD
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Diana L. Sylvestre, MD, reviews the complex management of hepatitis C in a patient with a history of drug and alcohol use and appearance of on-treatment psychiatric adverse effects.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe strategies for managing HCV patients with a history of recent alcohol or drug abuse
- Summarize strategies for managing HCV patients with substance use and psychiatric conditions
- Discuss strategies for identifying and managing HCV patients with mania vs depression
- Explain strategies for counseling patients on compliance and virologic response during HCV therapy
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Management of an Overweight Man With Genotype 1 Hepatitis C
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Raymond T. Chung, MD, discusses strategies for overcoming the barriers of insulin resistance, metabolic syndrome, and excess weight in a patient seeking HCV therapy.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Describe the relationships between HCV, HCV genotype, fatty liver disease, and the metabolic syndrome
- Discuss strategies for screening HCV patients pretreatment for insulin resistance and fatty liver disease
- Summarize strategies for managing insulin resistance and fatty liver disease in patients seeking treatment for chronic hepatitis C
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Management of a Treatment-Naive, 54-Year-Old Woman Experiencing Anemia and Virologic Breakthrough During HCV Therapy

- Tiffany A. Geahigan, PA-C, CCRC
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Tiffany Geahigan, PA-C, CCRC, presents a case highlighting key management issues for a treatment-naive patient with a history of obesity, type 2 diabetes, and hyperlipidemia.
Learning Objectives
Upon completion of this activity, participants should be able to:
- Discuss the importance of treatment adherence in achieving sustained virologic response in patients with hepatitis C
- Describe strategies for tailoring hepatitis C therapy based on on-treatment response
- Summarize data regarding the management of anemia during hepatitis C virus therapy
- List strategies for identifying and managing breakthrough during hepatitis C virus treatment
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CCO Slidesets
Overcoming Barriers to Hepatitis C Treatment
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Format: Microsoft PowerPoint (.ppt) |
File size: 1.32 MB
| Date posted: 7/22/2007
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Individualizing Therapy Based on Treatment History and On-Treatment Response
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Learn about the causes of nonresponse and strategies for individualizing treatment in patients with hepatitis C.
Format: Microsoft PowerPoint (.ppt) |
File size: 3.46 MB
| Date posted: 12/7/2007
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Interactive Tool
HCV RNA Monitoring An Interactive Decision Support Tool
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This interactive tool tracks a patient’s progress on therapy by calculating and graphically representing changes in HCV RNA over time. The tool also generates key patient evaluation dates and interprets the patient progress by providing definitions for endpoints of response and by reporting when a patient has reached these treatment goals. The tool has the capability to save patient data on the user’s own computer, making it available for editing upon subsequent uses.
Format: Adobe Flash (.swf)
| File size: 492 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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Jointly sponsored by Postgraduate Institute for Medicine and Clinical Care Options, LLC.
Contact Info
This program is supported by an independent educational grant provided by
Educational grants support only the CME-certified components of this program.
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