Hepatitis B Recognition and Care Determination in Primary Care

Hepatitis B Recognition and Care Determination in Primary Care

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Developed in Collaboration

Online Course | Specialties: Family Medicine, Internal Medicine, Primary Care
Released: 10/25/2021
Expires: 10/24/2022
Max Credits: 1.0
Continue to Course Read Abstract

Robert Gish, MD
Hepatitis B Foundation Medical Director
Asian Pacific Health Foundation Medical Director
Adjunct Professor, University of Nevada Reno School of Medicine
Clinical Professor, Adjunct, Department of Medicine, University of Nevada in Las Vegas
Adjunct Professor, UCSD, Skaggs School of Pharmacy and Pharmaceutical Sciences
Principal of Robert G Gish Consulting, LLC
San Diego, CA

Aekata Shah, DO
Family Physician
Jefferson Health Northeast
Philadelphia, PA

Patient Advocates
Alan Wang

William Amiteye

Activity Planners
Christie Avraamides, PhD
Clinical Content Manager
Baltimore, MD

Samantha Gordon, MS
Accreditation Manager
Baltimore, MD

Amy Sison
Director of CME
Baltimore, MD

Chari Cohen, DrPH, MPH
Senior Vice President
Hepatitis B Foundation
Doylestown, PA

Robert Danoff, DO, FACOFP, FAAFP
Program Director
Jefferson Health Northeast FM/EM Residency Program
American College of Osteopathic Family Physicians
Chicago, IL

Jennifer Gwilym, DO, FACOFP, FAAFP
Assistant Dean Clinical Education OU-HCOM
American College of Osteopathic Family Physicians
Chicago, IL

Joan Kulikowski
Manager of Member Education
American College of Osteopathic Family Physicians
Chicago, IL

Stephen Legault, MSW
Director of Knowledge, Learning and Assessment
American College of Osteopathic Family Physicians
Chicago, IL

Learning Objectives
Upon completion, participants should be able to:

  • Describe recommendations for HBV screening and testing, including evidence for universal testing
  • Outline approaches to overcome common patient- and provider-level barriers to testing and linkage to care in alignment with guidelines and recommendations
  • Detail recommendations for HBV treatment initiation and discontinuation, as well as long-term follow-up surveillance

Target Audience
This activity is intended for primary care providers.
Statement of Need
Approximately 2.4 million Americans are living with HBV infection. However, data continue to show that a significant percentage (65%-75%) of HBV-infected individuals are unaware of their infection. Furthermore, clinicians routinely underestimate the risks of viral hepatitis among their patients. Even when HBV is recognized, many patients do not receive evidence-based treatment, comprehensive care, or ongoing HCC surveillance. Primary care providers are essential to screening and testing patients for HBV, providing treatment, and conducting HCC surveillance.

Providership Statement
This activity was developed by Med-IQ in collaboration with ACOFP and the Hepatitis B Foundation.

Accreditation/Designation Statements
Med-IQ is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Med-IQ designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurse practitioners, physician assistants, and other healthcare professionals who successfully complete the activity will receive a Statement of Participation indicating the maximum credits available.

Instructions to Receive Credit
To receive credit, read the introductory CME material, watch the webcast, and complete the evaluation, attestation, and post-test, answering at least 70% of the post-test questions correctly.

Initial Release Date: October 25, 2021
Expiration Date: October 24, 2022
Estimated Time to Complete This Activity: 1 hour

Disclosure Policy
Med-IQ requires any person in a position to control the content of an educational activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines “relevant financial relationships” as those in any amount occurring within the past 24 months that could create a conflict of interest (COI). Individuals who refuse to disclose will not be permitted to contribute to this CME activity in any way. Med-IQ has policies in place that will identify and resolve COIs prior to this educational activity. Med-IQ also requires faculty to disclose discussions of investigational products or unlabeled/unapproved uses of drugs or devices regulated by the US Food and Drug Administration.

Drug/Product Usage by Faculty
Off-label/unapproved drug uses or products are mentioned within this activity. 

Disclosure Statement
The content of this activity has been peer reviewed and has been approved for compliance. The faculty and contributors have indicated the following financial relationships, which have been resolved through an established COI resolution process, and have stated that these reported relationships will not have any impact on their ability to give an unbiased presentation.

Robert Gish, MD
Consulting fees/advisory boards: Abbott Laboratories, AbbVie Inc., Access Biologicals, Altimmune, Antios Therapeutics, Arrowhead Pharmaceuticals, Inc., Bayer AG, BioCollections, Bristol-Myers Squibb, CymaBay Therapeutics, Dova Pharmaceuticals, Dynavax Technologies, Eiger BioPharmaceuticals, Eisai Inc., ENYO Pharma, eStudySite, Fibronostics, FortySeven, Inc., FUJIFILM Wako Chemicals, Genentech, Genlantis Inc., Gerson Lehrman Group, Gilead Sciences, Inc., Helios Pharmaceuticals, HepaTX, HepQuant, Intercept Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Lilly USA, LLC, Merck & Co., Inc., Prodigy Health, Quest Diagnostics, Salix Pharmaceuticals, Inc., Shionogi Inc., Viking Therapeutics
Fees received for promotional/non-CME activities: AbbVie Inc., Bristol-Myers Squibb, Eisai Inc., Gilead Sciences, Inc., Intercept Pharmaceuticals, Inc.
Ownership interest (stocks/stock options – excluding mutual funds): Eiger BioPharmaceuticals, Genlantis Inc., HepQuant, Angiocrine Bioscience, Riboscience LLC, Cocrystal Pharma, Inc.
Contracted research: Gilead Sciences, Inc.
Other: Topography Health

Aekata Shah, DO, has indicated no real or apparent conflicts.

Chari Cohen, DrPH, MPH
Consulting fees/advisory boards: Gilead Sciences, Inc., GlaxoSmithKline

The peer reviewers and other activity planners have no financial relationships to disclose.
Statement of Evidence-Based Content
Educational activities that assist physicians in carrying out their professional responsibilities more effectively and efficiently are consistent with the ACCME definition of continuing medical education (CME). As an ACCME-accredited provider of CME, Med-IQ has a policy to review and ensure that all the content and any recommendations, treatments, and manners of practicing medicine in CME activities are scientifically based, valid, and relevant to the practice of medicine. Med-IQ is responsible for validating the content of the CME activities it provides. Specifically, (1) all recommendations addressing the medical care of patients must be based on evidence that is scientifically sound and recognized as such within the profession; (2) all scientific research referred to, reported, or used in CME in support or justification of a patient care recommendation must conform to generally accepted standards of experimental design, data collection, and analysis.

Med-IQ is not liable for any decision made or action taken in reliance upon the information provided through this activity.
Contact Information
For questions or comments about this activity, please contact Med-IQ. Call (toll-free) 866 858 7434 or email

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The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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Complimentary CE
This activity is available free of charge to participants.

Acknowledgment of Commercial Support
This activity is supported by an educational grant from Gilead Sciences, Inc.


Here are the key takeaways from this activity. Deeper insights and evidence, plus an opportunity to receive credit, are available at the "Continue" button below.

  • Approximately 2.4 million people in the US have chronic HBV infection
  • The Hepatitis B Foundation recommends HBV screening for all adults
  • The recommended testing panel is the triple panel:
    • HBsAg
    • Anti-HBc
    • Anti-HBs
  • For patients with a positive test result, it is important to establish a follow-up care plan that includes routine monitoring and provides education on the potential long-term effects of HBV infection
  • Medical management is determined by HBV DNA levels, ALT levels, and liver fibrosis stage
  • Patients who are not treated need to be monitored every 6 months indefinitely
  • For patients who are eligible for treatment, the first-line medications include entecavir, tenofovir disoproxil, and tenofovir alafenamide
  • HCC (hepatocellular carcinoma, primary liver cancer) surveillance includes routine ultrasonography and blood tests (eg, AFP)

View reference list.

Click “Continue” to proceed through this activity and/or receive credit. To receive credit and a certificate, you must complete all of the chapters in this activity.

By clicking "Continue," you confirm that you have reviewed the CME information.


Unless otherwise indicated, photographed subjects who appear within the content of this activity or on artwork associated with this activity are models; they are not actual patients or doctors.

The information provided through this activity is for continuing education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient’s medical condition.

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