The Management of Hepatitis C Virus Infection in Patients with Advanced Kidney Disease

Hemodialysis International
Volume 22, Supplement 1, April 2018

Guest Editor: Craig E. Gordon, MD, MS

Release date: April 2018
Expiration date: April 2019
Estimated time to complete activity: 1.25 hours (nurses) |2.0 hours (physicians)

This activity is jointly provided by Medical EducationResources and John Wiley & Sons, Inc.

This activity is supported by an educational grant from Merck Sharp & Dohme Corp.


Statement of Need/Program Overview
With ongoing transmission of HCV in hemodialysis units and historically low rates of HCV treatment in hemodialysis and kidney transplant recipients, physician and nursing staff may lack awareness and performance in maintaining hygienic precautions to reduce blood-borne pathogen transmission, and may not be familiar with novel direct acting antiviral agents (DAA) and their safety/efficacy in hemodialysis/transplantation.

Target Audience
This activity has been designed to meet the educational needs of physicians, nurses, and caregivers involved in the care of patients with Hepatitis C Infection in Advanced Kidney Disease. All articles in this activity are relevant for Continuing Medical Education. Four articles are relevant for Continuing Nursing Education. Please see Program Agenda for full list of articles.

Learning Outcomes
To implement these practices, reducing the rate of HCV transmission in hemodialysis and gain understanding of when and which populations to recommend HCV treatment with DAAs.

Educational Objectives

After completing this activity, the participant should be better able to:
1. Implement proper precautions against infection with hepatitis C for patients and staff in hemodialysis facilities
2. Integrate treatments with direct acting antiviral agents for hepatitis C into the treatment of patients with advanced kidney disease and hepatitis C infection
3. Discuss therapeutic strategies for the treatment of hepatitis C in the kidney transplant system
4. Integrate into multidisciplinary teams of clinicians treating patients with advanced kidney disease and hepatitis C infection in the kidney transplant setting

Planners: John Daugirdas, MD; Craig Gordon, MD; Veronda Smith, FNP-BC

Authors: Agarwal, Adhish; Al Marji, Catreena; Berenguer, Marina; Box, Terry; Chitalia, Vipul; Chung, Raymond T; Chute, Donald F; Cohen-Bucay, Abraham; Dejman, Adriana; Elias, Nahel; Francis, Jean; Gordon, Craig; Gustafson, Jenna; Hall, Isaac; Jadoul, Michel; Ladino, Marco; Laith Al-Rabadi; Mendizabal, Manuel; Nader, Claudia; Nunes, David; O. Silva, Marcelo; Ortiz, Guillermo A; Puchades Renau, Lorena; Reddy, Yuvaram N V; Renau, Lorena Puchades; Ridruejo,Ezequiel; Roth, David; Rudledge, Stephanie; Singhania, Girish; Sise, Meghan Elizabeth; Tran, Huy; Trivedi, Hirsh D; Williams, Winfred W; Wojciechowski, David

This activity underwent peer review in line with the standards of editorial integrity and publication ethics of John Wiley & Sons, Inc. Conflicts of interest have been identified and resolved in accordance with John Wiley and Sons, Inc.’s Policy on Activity Disclosure and Conflict of Interest.

Program Agenda
 -Introduction to hepatitis C virus infection: Overview and history of hepatitis C virus therapies*
 -Pharmacokinetics and drug interactions of medications used to treat hepatitis C virus infection in the setting of chronic kidney disease and kidney transplantation.
 -Treatment and management options for the hepatitis C virus infected kidney transplant candidate.*
 -Rationale for treatment of hepatitis C virus infection in end-stage renal disease patients who are not kidney transplant candidates
 -Hepatitis C virus infection in kidney transplantation – changing paradigms with novel agents
 -Timing of hepatitis C virus infection treatment in kidney transplant candidates*
 -Transplantation of hepatitis C virus infected kidneys into hepatitis C virus uninfected recipients
 -Treatment of hepatitis C virus infection in patients with mixed cryoglobulinemic syndrome and cryoglobulinemic glomerulonephritis
 -Rationale for treating hepatitis C virus infection in patients with mild to moderate chronic kidney disease
 -The prevention of hepatitis C virus transmission to hemodialysis patients and staff members*

*- article is relevant for nursing participants

Nursing Credit

Medical Education Resources is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. This CE activity provides 1.25 contact hours of continuing nursing education.
Medical Education Resources is a provider of continuing nursing education by the California Board of Registered Nursing, Provider #CEP 12299, for 1.25 contact hours For questions related to nursing credit, please contact MER at 800-421-3756

Physician Credit
John Wiley and Sons, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. John Wiley and Sons, Inc. designates this Enduring Material activity for a maximum of 2.0 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. For information on applicability and acceptance of continuing medical education credit for this activity, please consult your professional licensing board.

Disclosure of Conflicts of Interest

Medical Education Resources (MER) ensures balance, independence, objectivity, and scientific rigor in all our educational programs. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure that all scientific research referred to, reported, or used in a continuing education activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality activities that promote improvements or quality in health care and not the business interest of a commercial interest.

The authors reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:
Name of Faculty Reported Financial Relationship
David Roth, MD - Consultant and Scientific Advisory Board: Merck, AbbVie.
David Wojciechowski, MD - Research grants to the institution: Novartis, Bristol-Myers Squibb, Oxford Immunotec, Merck, Shire, CSL Behring. Scientific advisory board participant: Merck, Bristol-Myers Squibb.
Jean Francis, MD - Consultant: Alexion Pharmaceuticals
Meghan E. Sise, MD - Research grants to the institution: Gilead Sciences, Abbvie, Merck. Scientific advisory board participant: Abbvie and Merck. Consultant to Abbvie
Raymond T Chung, MD - Research grants to the institution: Gilead Sciences, Abbvie, Merck, Bristol-Myers Squibb, Janssen

The content managers reported the following financial relationships with commercial interests whose products or services may be mentioned in this activity:
Name of Content Manager - Reported Financial Relationship
John Daugirdas, MD - No financial relationships to disclose
Craig Gordon, MD - Consultant: Alexion pharmaceutics; Advisory board: Abbvie
Veronda Smith, FNP-BC - No financial relationships to disclose

Method of Participation:

There are no fees for participating in and receiving credit for this activity. During the period April, 2018 through April, 2019, participants must 1) read the learning objectives and faculty disclosures, 2) study the educational activity, 3) complete the posttest by recording the best answer to each question in the answer key on the evaluation form with a score of 70% or better, 4) complete the evaluation form 5) download certificate.


The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Medical Education Resources, John Wiley & Sons, Inc., and/or Merck Sharp & Dohme Corp. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.

Fee Information
There is no fee for this educational activity

MER Privacy Policy
Medical Education Resources and John Wiley & Sons, Inc. maintain high standards for the protection of privacy over the Internet. The purpose of this statement is to explain what information we obtain, how it is used, and how visitors can restrict its use or disclosure.
The only information MER obtains is information supplied voluntarily by the visitor.
We do not sell or disclose individually identifiable information obtained online unless it is required by law or disclosure is necessary to protect the safety of customers, employees, or property.
We use the information to grade your posttest and to send you a certificate of completion of the activity. If we use a third-party company to grade your posttest and issue certificates of completion, we will give the information to that company for that purpose only.
For each activity that you take, you must complete an evaluation questionnaire. That questionnaire asks if you are willing to participate in a follow-up survey. If you answer yes, we will use your name and contact information to send you the survey.
We may use the information to invite you to participate in other activities that we may offer.
Medical Education Resources is committed to safeguarding customer privacy, and we require our employees to protect the privacy of information about our customers. Should you wish to delete your information from our files or discuss our privacy policy, please contact us.