By Morgan Fincham, AASLD Staff
Dr. Robert Perrillo chairs the Hepatitis B Special Interest Group (SIG) which was launched last year. This is AASLD’s largest SIG with approximately 150 members, including many who are distinguished international members. Dr. Perrillo is the Director of the Transplant Hepatology Fellowship Program at Baylor University Medical Center in Dallas. Prior to joining the Hepatology Division at Baylor in 2006, Dr. Perrillo was Director of Academic Affairs, Section of Gastroenterology and Hepatology at the Ochsner Clinic Foundation in New Orleans, and Clinical Professor of Medicine at Tulane University. Dr. Perrillo is internationally recognized for his work on antiviral therapy of chronic hepatitis B. He is an opinion leader in this area and has been actively engaged in treatment of hepatitis B since the early 1980s. Heavily involved in both education and research, Dr. Perrillo was the logical choice to lead this group.
Dr. Perrillo and a seven person Steering Committee have recently begun the important task of educating other medical specialists about the importance of hepatitis B as a preventable and treatable disorder. It is his opinion that while progress in our knowledge of hepatitis B has been vast, we continue to see a big knowledge gap among primary care providers, mid-level providers, oncologists, rheumatologists, dermatologists, and even gastroenterologists. Critical to this failure, Dr. Perrillo believes, is the tendency for educators to provide the same message to all groups. “We do not,” he asserts, “tailor education on a need to know basis.” He feels that this can lead to confusion because hepatitis B is a complex disorder and physicians may not see a large volume of these patients which would otherwise compel them to have better understanding. Dr. Perrillo feels that a potential solution to this communication problem can come from the development of AASLD endorsed slide modules for various medical specialists and subspecialists that are presented in a simple, yet comprehensive way.
Dr. Perrillo, the Steering Committee members, and their colleagues within the broader membership of the hepatitis B SIG will produce this material over the next several months. The materials will then be presented to educational leaders within the national organizations of the relevant medical providers (primary providers, mid-level providers, oncologists, rheumatologists, dermatologists, gastroenterologists, and obstetricians) before making them available on the AASLD website.
The slides will be posted free of charge to non-members if brief demographical
information is provided. This information will allow AASLD to learn who is accessing the program and gain knowledge of their years in practice as well as exposure to patients with hepatitis B. Dr. Perrillo feels that this approach is likely to reach a much broader group of individuals than would a presentation at one of their national society meetings. Furthermore, as knowledge expands that is relevant to their practice, it can be added to the slide sets.
Among other things, the slides will emphasize the global relevance of hepatitis B, the importance of serologic screening, when and how to provide screening for hepatocellular carcinoma, when to consider referral to a liver specialist for further care options, and the dangers of HBV reactivation when immune suppressing medications are provided. Not all slide modules will carry the same message, but instead each will be tailored to what a practicing clinician representing a specific medical area needs to know.
Dr. Perrillo indicates that the timing is just right for this approach. He points out that the Institute of Medicine released a report on January 11, 2010, describing a failure in many quadrants to screen and appropriately vaccinate for hepatitis B. “The slides will be consistent with current AASLD, CDC, and IOM recommendations but provide practical and useful insights as well into the reasons behind these recommendations,” he states.
A brief text description of the content of each slide will be provided to facilitate learning. Dr. Perrillo hopes that this will also lead to the internal utilization of these materials at conferences within the medical provider’s practice. Furthermore, the intent is to have the slides replete with true case examples to illustrate the importance of appropriate medical decisions and the adverse outcomes that may follow incorrect decisions.
Dr. Perrillo is enthusiastic that the hepatitis B SIG may also allow the development of international registries to address how varied medical interventions affect disease outcome. Examples include tracking HBsAg clearance in response to various antiviral drug therapies, and how different routes and duration of hepatitis B immune globulin impact hepatitis B recurrence post-transplant, now that potent oral antiviral therapy has become available. The latter, he points out, has tremendous cost implications. Dr. Perrillo has begun the task of seeking outside financial support for such endeavors.
Dr. Perrilllo looks forward to the availability of the slide modules this year and hopes to have several months of practical experience with them by the time of this year’s annual meeting. The members of the Steering Committee who will help lead this effort are: Jenny Heathcote, Steve Locarnini, Brian McMahon, Marion Peters, Tram Tran, Norah Terrault, and Geoff Dusheiko.