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Case Clinic 3: A 29-Year-Old Caucasian Man With a History of Injected Drug Use

Case Clinic 3: A 29-Year-Old Caucasian Man With a History of Injected Drug Use


Patient Case Study

Time to Complete

30 minutes


November 30, 2017


November 30, 2018
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Maximum Credits

0.50 / AMA PRA Category 1 CreditTM

Accredited Provider

This educational activity is provided by the American Gastroenterological Association.

Commercial Supporter

Supported by an educational grant from Merck & Co., Inc.


Produced by Haymarket Medical Education (HME)

Program Description

The opiate epidemic has led to a dramatic increase in the incidence of new, acute hepatitis C virus (HCV) infection in the United States since 2006—a trend that is closely associated with increases in injection drug use (IDU). Furthermore, co-infection with hepatitis B and human immunodeficiency virus is not uncommon. Clinicians are challenged to determine the optimal approach to treatment in these patients, which demands selecting the appropriate treatment regimen based on viral genotypes and subtypes as well as employing protocols that promote treatment efficacy and minimize the risk of HCV treatment resistance.

Intended Audience

Gastroenterologists, hepatologists, primary care clinicians, and other providers who treat patients with hepatitis C

Educational Objectives

At the conclusion of this activity, participants should be better able to:

  • Select the appropriate direct-acting antiviral (DAA) agent for hepatitis C virus (HCV) infection based on viral genotypes (and subtype) and associated complications
  • Identify the emergence of HCV resistance-associated substitutions (RASs; also known as resistance-associated variants [RAVs]) following treatment with selected DAA regimens
  • Implement strategies, including the spectrum of molecular testing protocols, to identify and monitor disease progression and treatment efficacy and potentially avert HCV treatment resistance

Conflict Of Interest Disclosure Policy

In accordance with the ACCME’s Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any financial relationship(s) or other relationship(s) held within the past 12 months. The AGA Institute implements a mechanism to identify and resolve all conflicts of interest prior to delivering the educational activity to learners.


Mark Sulkowski, MD
Professor of Medicine
Johns Hopkins University
Medical Director
Viral Hepatitis Center
Division of Infectious Diseases
Johns Hopkins Hospital
Baltimore, MD

Dr. Sulkowski receives consulting fees from AbbVie Inc., Gilead Sciences, Inc., Janssen Pharmaceuticals, and Merck & Co., Inc.

Accredited Provider and Publishing Staff Disclosures

No other individuals involved with planning and delivering the content disclosed any relevant financial relationships.




AMA PRA Category 1 Credit(s)TM

Accreditation Statement

The AGA Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

The AGA Institute designates this enduring activity for a maximum of 0.50 AMA PRA Category 1 CreditTM  . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure of Unlabeled Use

This educational activity may contain discussion of approved and/or investigational uses of agents that are not indicated by the FDA. AGA Institute, Haymarket Medical Education, and Merck & Co., Inc., do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of AGA Institute, Haymarket Medical Education, and Merck & Co., Inc. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


AGA Institute does not provide any warranty as to the accuracy or reliability of information presented either verbally or in writing by presenters. No responsibility is assumed by AGA Institute for any injury and/or damage to persons or property resulting from any use of such information.

If you have any questions relating to the accreditation of this activity, please contact the AGA education department at or 301-654-2055.


To obtain credit, a score of 70% or better on the post-test is required. This activity is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test and evaluation, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME within your Profile/CME History, which you can access at any time.

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