453. Transdisciplinary approach to managing hepatitis C virus infection in patients at a tertiary care cancer center
Session: Poster Abstract Session: Innovations in Medical Education
Thursday, October 8, 2015
Room: Poster Hall
Posters
  • Transdisciplinary approach to managing HCV infection in patients at a tertiary care cancer center_V5.pdf (347.9 kB)
  • Background: Hepatitis C virus (HCV) infection is difficult to treat in cancer patients (pts). We report the educational experience from our center focused on HCV care of pts with various types of malignancies. 

    Methods:  In 8/2009, a clinic devoted to managing HCV infection in cancer pts was started in our center by infectious diseases (ID) specialists in collaboration with hepatologists. Multidisciplinary educational activities were implemented to train nurses, mid-level providers, public health students, prospective internal medicine residents, ID fellows, and ID providers. To understand the strengths and limitations of diagnosis and management of this unique population and to establish best practices, all clinic pts were evaluated following a standardized approach.

    Results:  Between 8/2009 and 4/2015, 475 HCV-infected cancer pts were evaluated in the clinic. Pts were monitored for liver disease progression, eligibility for antiviral therapy (AVT), drug interactions, adverse events of AVT, and outcomes. Clinic nurses provided care to patients, facilitated insurance approval of treatment, assessed side effects of AVT, and educated pts/caregivers. Since 2009, 30 nurses have been trained and over 600 pts/caregivers educated on HCV infection. Seven mid-level providers were trained to deliver HCV care. In 2014, four ID fellows joined the clinic as an elective rotation. A formal training for managing HCV in cancer pts was begun in 2015 with a mandatory continuity clinic for ID fellows. Six research fellows have presented clinic data in more than 30 professional meetings, and published 15 articles in peer-reviewed journals including various aspects of epidemiology, oncogenesis, complications, and treatment outcomes. Future plans include evaluation of pt/caregivers knowledge and attitudes regarding HCV and AVT.  Management guidelines are being developed for HCV-infected cancer patients related to rapidly changing standard of care.    

    Conclusion: Educational efforts focused on HCV care in cancer pts provide transdisciplinary learning opportunities for nurses, mid-level providers, public health students, and physicians in training. This training experience could be replicated in other academic centers in the US.

    Harrys a. Torres, MD1, Lillian Roach, RN-BC1, Parag Mahale, MBBS, MPH1, Bruno Granwehr, MD1, Boris Blechacz, MD2, Ethan Miller, MD2, Roy Borchardt, PA1, Bhavarth Shukla, MD, MPH1, Charles Ericsson, MD, FIDSA3 and Issam Raad, MD, FACP, FIDSA, FSHEA4, (1)Infectious Diseases, Infection Control, and Employee Health, The University of Texas MD Anderson Cancer Center, Houston, TX, (2)Gastroenterology, Hepatology, and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, TX, (3)University of Texas Medical School At Houston, Houston, TX, (4)Infectious Diseases, Infection Control & Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX

    Disclosures:

    H. A. Torres, None

    L. Roach, None

    P. Mahale, None

    B. Granwehr, None

    B. Blechacz, None

    E. Miller, None

    R. Borchardt, None

    B. Shukla, None

    C. Ericsson, None

    I. Raad, UT MD Anderson Cancer Center: Shareholder , Licensing agreement or royalty
    Novel Anti-Infective Technologies LLC: Shareholder , Licensing agreement or royalty

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.