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Self-Study Modules and Sections

  1. For any clinician who may encounter persons with hepatitis C virus infection and would like to establish core competence in testing for hepatitis C, counseling patients on preventing hepatitis C transmission, and diagnosing acute hepatitis C infection.
  2. Intended for clinicians involved in long-term management of persons with chronic hepatitis C infection. Content includes initial evaluation, natural history, preventing liver damage, staging of liver fibrosis, evaluation of cirrhosis, surveillance for hepatocellular carcinoma, and recognition of extrahepatic manifestations.
  3. Addresses the diagnosis and management of complications that may arise in person with chronic HCV infection and cirrhosis, including ascites, spontaneous bacterial peritonitis, varicies, hepatic encephalopathy, and referral for liver transplantation.
  4. For clinicians evaluating persons with chronic HCV infection for hepatitis C treatment, including clinicians who will independently assess treatment candidacy and clinicians who will provide treatment candidacy with assistance from a hepatitis C expert.
  5. For clinicians treating chronic hepatitis C infection. Material covered includes recommendations for treatment-naïve and treatment-experienced persons with chronic HCV infection genotypes 1-6, based on the Association for the Study of Liver Diseases and Infectious Diseases Society of America (AASLD-IDSA) HCV Guidance.
  6. Designed for clinicians who manage key populations of persons living with HCV and/or complex HCV-related unique treatment issues. Material covered is at an advanced level.

Core Competencies for the Hepatitis C Online

It is the goal of Hepatitis C Online to provide ongoing, up-to-date information needed to meet the core competency knowledge for HCV prevention, screening, diagnosis, and ongoing treatment and care to healthcare providers in the United States.

The following is an outline and list of Core Competency Sections (with sub-competency topics and learning objective performance indicators).

Section 1. Screening and Diagnosis of Hepatitis C Infection

Section Core Competency
Apply Evidence-Based Recommendations to Provide Screening and Diagnosis of HCV Infection
Topics
Learning Objective Performance Indicators
  1. Describe the epidemiology of hepatitis C in the United States.
  2. Recognize the impact of the hepatitis C epidemic in the United States.
  1. Summarize CDC screening and testing recommendations for chronic hepatitis C infection.
  2. Discuss the impact of the 1945 to 1965 birth cohort hepatitis testing on the hepatitis C epidemic.
  1. Describe screening and supplemental tests used for diagnosing hepatitis C infection.
  2. Discuss post-test counseling messages and linkage to care for persons with active hepatitis C virus infection.
  1. Summarize common routes of hepatitis C transmission.
  2. Discuss appropriate counseling to prevent transmission of hepatitis C virus. 
  1. Recognize the clinical features, if present, in patients with acute hepatitis C infection. 
  2. List appropriate tests to order for the laboratory diagnosis of acute hepatitis C infection.

Section 2. Evaluation, Staging, and Monitoring of Chronic Hepatitis C

Section Core Competency
Provide Evidence-Based Evaluation, Staging, and Monitoring to Persons with Chronic Hepatitis C Infection
Topics
Learning Objective Performance Indicators
  1. Summarize key aspects of the medical history and physical examination in persons with hepatitis C presenting for an initial evaluation.
  2. List key immunizations that should be administered to persons with chronic hepatitis C infection.
  1. Describe the variable outcomes that can occur in persons with chronic HCV infection.
  2. Discuss factors that influence the rate of progression of fibrosis in persons with chronic HCV infection.
  1. Determine which common liver health counseling messages should be addressed in persons with chronic hepatitis C infection.
  2. Summarize key counseling messages related to over-the-counter medications, alcohol, marijuana, diet, and complementary medications in persons with chronic hepatitis C infection. 
  1. Explain the indications, risks, and histologic assessment for liver biopsy in persons with chronic hepatitis C infection.
  2. Examine noninvasive tests of liver fibrosis and examine the potential clinical utility of these tests. 
  1. Differentiate compensated cirrhosis from decompensated cirrhosis. 
  2. Summarize classification and prognostic systems for patients with cirrhosis. 
  1. Determine which patients with chronic hepatitis C infection should undergo hepatocellular carcinoma surveillance.
  2. Describe the American Association for the Study of Liver Diseases (AASLD) recommendations for surveillance for hepatocellular carcinoma.
  1. Recognize the clinical syndromes associated with hepatitis C-related cryoglobulinemia.
  2. Describe the renal and dermatologic extrahepatic manifestations associated with chronic hepatitis C infection.

Section 3. Management of Cirrhosis-Related Complications

Section Core Competency
Apply Evidence-Based Recommendations to Management of Cirrhosis-Related Complications in Persons with HCV Infection
Topics
Learning Objective Performance Indicators
  1. Describe the appropriate technique for performing abdominal paracentesis.
  2. Summarize appropriate medical management and dietary recommendations for patients with ascites. 
  1. Differentiate spontaneous bacterial peritonitis from secondary bacterial peritonitis.
  2. Select and utilize appropriate antimicrobial therapy for patients with spontaneous bacterial peritonitis.
  1. Identify which patients with cirrrhosis should receive primary prophylaxis against variceal bleeding.
  2. Use nonselective beta-blockers as prophylaxis against variceal bleeding when prophylaxis is indicated.
  1. Summarize the clinical features of patients with hepatic encephalopathy and describe specific diagnostic tests.
  2. Utilize appropriate medical therapy for patients with hepatitic encephalopathy.
  1. Summarize the major indications and important timing events for liver transplantation evaluation referral.
  2. Determine a MELD score for all patients with cirrhosis and reflect on whether the score indicates a need for liver transplantation referral.

Section 4. Evaluation and Preparation for Hepatitis C Treatment

Section Core Competency
Provide Evidence-Based Evaluation and Preparation for Treatment of Persons with Hepatitis C Infection
Topics
Learning Objective Performance Indicators
  1. Discuss the goals and rationale for hepatitis C therapy with patients considering treatment.
  2. Predict a patient's response to treatment for chronic hepatitis C infection based on specific host and viral factors.
  1. Reflect on the indications, contraindications, and patient readiness when considering initiating hepatitis C therapy.
  2. Integrate knowledge of new medications when considering the timing of initiating hepatitis C therapy.
  1. Summarize the costs of direct-acting antiviral agents used to treat hepatitis C.
  2. Describe major steps in accessing new direct-acting antiviral medications used to treat hepatitis C.
  1. List different methods to measure patient adherence when receiving hepatitis C therapy.
  2. Identify barriers to adherence and discuss strategies that can maximize adherence.

Section 5. Treatment of Chronic Hepatitis C Infection

Section Core Competency
Apply Evidence-Based Treatment of Chronic Hepatitis C Infection
Topics
Learning Objective Performance Indicators
  1. Discuss preferred therapies for initial treatment of patients with genotype 1a or 1b chronic HCV.
  2. List the preferred therapy for retreatment of patients with HCV genotype 1a or 1b chronic infection who have previously failed therapy.
  1. List preferred therapies for initial treatment of patients with genotype 2 chronic HCV.
  2. Describe the preferred therapy for retreatment of patients with HCV genotype 2 chronic infection who have failed prior therapy.
  1. List preferred therapies for initial treatment of patients with genotype 3 chronic HCV.
  2. Describe the preferred therapy for retreatment of patients with HCV genotype 3 chronic infection who have failed prior therapy.
  1. Understand the preferred therapies for the intial treatment of patients with genotype 4 chronic HCV.
  2. State the preferred therapy for retreatment of patients with HCV genotype 4 chronic infection in whom prior therapy has failed.
  1. List the preferred therapies for the initial treatment of patients with genotype 5 or 6 chronic HCV.
  2. Discuss the preferred approach to retreatment of patients with HCV genotype 5 or 6 chronic infection who have failed prior therapy.
  1. List the recommended monitoring for treatment efficacy and safety in patients receiving hepatitis C therapy.
  2. Summarize appropriate monitoring for patients after treatment for hepatitis C.

Section 6. Treatment of Key Populations and Unique Situations

Section Core Competency
Apply Evidence-Based HCV Treatment to Key Populations and in Unique Situations
Topics
Learning Objective Performance Indicators
  1. Explain the concept of spontaneous HCV clearance after acute infection and how this impacts treatment strategies.
  2. Formulate an approach to evaluation and treatment of persons with acute hepatitis C infection.
  1. Discuss key studies using direct-acting antiviral agents to treat hepatitis C in persons coinfected with HIV.
  2. Develop an understanding of recommended approach to treating hepatitis C in persons with HIV coinfection.
  1. Explain the interaction of hepatitis C and renal disease.
  2. Discuss hepatitis C treatment approaches in persons with chronic renal insufficiency.
  1. Provide appropriate hepatitis C treatment options for persons with compensated cirrhosis.
  2. Discuss approaches to treatment of hepatitis C in persons with decompensated cirrhosis.
  1. Summarize the impact of substance use on HCV treatment decisions in the modern era of treatment with direct-acting antiviral agents.
  2. Integrate support services and management strategies into programs for patients with substance use who have chronic hepatitis C infection.
  1. Summarize the prevalence data and importance of addressing HCV in the correctional setting.
  2. Discuss challenges of treating HCV in corrections.

Progress Tracker - 2nd Edition

Self-Study Module 1
For any clinician who may encounter persons with hepatitis C virus infection and would like to establish core competence in testing for hepatitis C, counseling patients on preventing hepatitis C transmission, and diagnosing acute hepatitis C infection.
Self-Study Module 2
Intended for clinicians involved in long-term management of persons with chronic hepatitis C infection. Content includes initial evaluation, natural history, preventing liver damage, staging of liver fibrosis, evaluation of cirrhosis, surveillance for hepatocellular carcinoma, and recognition of extrahepatic manifestations.
Self-Study Module 3
Addresses the diagnosis and management of complications that may arise in person with chronic HCV infection and cirrhosis, including ascites, spontaneous bacterial peritonitis, varicies, hepatic encephalopathy, and referral for liver transplantation.
Self-Study Module 4
For clinicians evaluating persons with chronic HCV infection for hepatitis C treatment, including clinicians who will independently assess treatment candidacy and clinicians who will provide treatment candidacy with assistance from a hepatitis C expert.
Self-Study Module 5
For clinicians treating chronic hepatitis C infection. Material covered includes recommendations for treatment-naïve and treatment-experienced persons with chronic HCV infection genotypes 1-6, based on the Association for the Study of Liver Diseases and Infectious Diseases Society of America (AASLD-IDSA) HCV Guidance.
Self-Study Module 6
Designed for clinicians who manage key populations of persons living with HCV and/or complex HCV-related unique treatment issues. Material covered is at an advanced level.
Lesson 1 
 
 
 
 
 
Lesson 2 
 
 
 
 
 
Lesson 3 
 
 
 
 
 
Lesson 4 
 
 
 
 
 
Lesson 5 
 
 
 
 
Lesson 6 
 
 
Lesson 7 

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