FAQ: HCV: Is It Still an Issue?

Despite advances in hepatitis C treatment, why does hepatitis C virus (HCV) remain a significant public health concern, and what can healthcare providers do to improve diagnosis and access to care? In this educational video, Scott Springer, PA-C, a healthcare professional specializing in hepatology and addiction medicine in Buffalo, New York, discusses the ongoing challenges of hepatitis C screening, diagnosis, and treatment and the critical role advanced practice providers (APPs) can play in addressing gaps in care. Although highly effective direct-acting antiviral (DAA) therapies can cure most hepatitis C infections in just 8–12 weeks, many individuals remain undiagnosed or face barriers to accessing treatment. Springer explores strategies to simplify HCV screening and expand treatment opportunities across primary care, addiction medicine, gastroenterology, and hepatology settings. Learn how point-of-care hepatitis C testing, dried blood spot testing, reflex HCV RNA testing, and noninvasive liver fibrosis assessments, including the FIB-4 score, can help streamline diagnosis and reduce unnecessary patient visits. The discussion also highlights the importance of simplifying pretreatment evaluations, improving access to antiviral medications, and expanding hepatitis C treatment beyond specialty clinics. Discover how nurse practitioners, physician assistants, and other healthcare professionals can help close the gap between hepatitis C diagnosis and treatment, improve patient outcomes, and advance efforts toward hepatitis C elimination. Whether you work in hepatology, gastroenterology, primary care, or addiction medicine, this video provides practical insights into making hepatitis C care more accessible, efficient, and patient-centered.

What are the most common complications after liver transplantation, and how can healthcare providers recognize and manage them to improve patient outcomes? In this educational session from the 9th Annual GHAPP National Conference, Edith Johannes explores the clinical and emotional challenges patients face before and after liver transplant surgery. This discussion highlights the psychological impact of chronic liver disease, including grief, loss of independence, and the emotional journey from transplant evaluation to recovery. Learn about critical post-liver transplant complications, including primary graft nonfunction, early allograft dysfunction, hepatic artery thrombosis (HAT), ischemic cholangiopathy, biliary strictures, infections, and acute and chronic liver transplant rejection. The presentation examines the differences between early and late hepatic artery thrombosis, the importance of monitoring liver function tests (LFTs), and the role of magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) in diagnosing and treating biliary complications. Additional topics include immunosuppression-related infection risks, antibody-mediated rejection, donor-specific antibodies, and the long-term impact of medication nonadherence on graft survival. Discover why early recognition of transplant complications, careful interpretation of elevated liver enzymes, and timely clinical intervention are essential for protecting graft function and supporting long-term transplant success. Designed for hepatology nurse practitioners, physician assistants, gastroenterology providers, and other advanced practice providers (APPs), this session offers valuable insights into post-transplant monitoring, complication management, and the importance of addressing both the physical and psychological needs of liver transplant recipients.

What does it take to bring one of the leading gastroenterology and hepatology conferences for advanced practice providers (APPs) to life? In this behind-the-scenes podcast, GHAPP board members Christina Hanson, FNP-C, Amy Ladewski, PA-C, and Patrick Horne, NP, share an inside look at the planning, collaboration, and dedication behind the GHAPP National Conference. From developing a comprehensive educational agenda and selecting relevant GI and hepatology topics to coordinating expert faculty, workshops, boot camps, and networking opportunities, discover how GHAPP continues to elevate professional education for nurse practitioners (NPs) and physician assistants (PAs). The discussion explores the evolution of GHAPP National over the past nine years, growing from approximately 100–150 attendees to more than 1,400 healthcare professionals, while maintaining its mission to educate, elevate, and empower APPs in gastroenterology and hepatology. Learn how this APP-led organization fosters mentorship, peer-to-peer learning, clinical collaboration, leadership development, and meaningful professional connections for both new and experienced GI and hepatology providers. The panel also highlights the importance of attendee feedback, innovative continuing medical education, and expanding access to educational resources through regional programs, podcasts, and scholarship opportunities. As GHAPP prepares to celebrate its 10th anniversary at GHAPP National 2027 in Dallas, hear what makes this conference a unique and supportive community for advanced practice providers dedicated to advancing GI and hepatology care.

How is artificial intelligence transforming gastroenterology, and is it truly improving patient care or simply generating hype? In this video, Sarah Enslin, PA-C, of the University of Rochester Medical Center, explores the evolving role of AI in gastroenterology and its potential to enhance clinical efficiency, diagnostic accuracy, and patient outcomes. From AI-assisted colonoscopy and computer-aided polyp detection (CADe) to computer-aided diagnosis (CADx), generative AI, and predictive analytics, discover how emerging technologies are shaping the future of GI practice. Sarah discusses how AI tools can support colorectal cancer screening, improve adenoma detection rates, streamline clinical documentation, and reduce administrative burdens for advanced practice providers (APPs). She also highlights practical applications of large language models, including ChatGPT and OpenEvidence, for clinical information synthesis and generating letters of medical necessity, as well as ambient AI documentation tools such as DAX Copilot. Looking ahead, explore the potential of AI in pancreatic cancer detection, hepatocellular carcinoma risk prediction, personalized screening strategies, and electronic health record (EHR) workflow optimization. Learn how healthcare professionals can evaluate AI technologies based on FDA regulatory status, clinical evidence, real-world effectiveness, and meaningful patient outcomes while recognizing the importance of maintaining clinical judgment and oversight. Whether you're a gastroenterology nurse practitioner, physician assistant, or other healthcare professional, this discussion offers valuable insights into the benefits, limitations, and future of artificial intelligence in GI and hepatology.

Discover the GHAPP Peer Network, a collaborative community designed to connect gastroenterology (GI), hepatology, and other advanced practice providers (APPs) nationwide. In this video, nurse practitioners HoChong Gilles, Oyin Penny, and Suzanne Robertazzi introduce the GHAPP Peer Network and explore how this innovative platform supports peer-to-peer learning, clinical collaboration, mentorship, and professional development beyond the GHAPP ACE 2.0 educational experience. Through the GHAPP ACE 2.0 app, healthcare professionals can connect with GI and hepatology experts, ask clinical questions, share educational resources, discover career opportunities, and engage with colleagues who share similar clinical interests and specialties. Whether you're an experienced nurse practitioner, a new APP entering gastroenterology or hepatology, or a primary care provider seeking specialty insights, the GHAPP Peer Network offers opportunities to expand your professional network, strengthen clinical knowledge, and translate education into everyday patient care. Learn how to create your profile, connect with mentors, explore upcoming educational events, and build meaningful professional relationships that extend beyond national conferences. Download the GHAPP ACE 2.0 app and join the Peer Network today to connect, collaborate, and grow alongside fellow healthcare professionals.

Christina Hanson, FNP, and Dr. Marcelo Kugelmas of South Denver Gastroenterology review linerixibat, an ileal bile acid transporter (IBAT) inhibitor, and its role in managing cholestatic pruritus in primary biliary cholangitis (PBC). This medication review podcast explores how blocking bile acid reabsorption in the ileum targets a pathway involved in persistent itching. The discussion covers the phase 2 GLIMMER study and phase 3 GLISTEN trial, including findings on itch reduction, sleep interference, and treatment response in patients with moderate to severe pruritus. The speakers also examine safety and tolerability considerations, including diarrhea, abdominal pain, nausea, elevated liver enzymes, and treatment discontinuation. Additional topics include preliminary results from the linerixibat long-term safety and tolerability study (LLSAT), maintenance of itch relief, and the need for further research on combining linerixibat with PPAR agonists. Designed for nurse practitioners, physician assistants, and other gastroenterology and hepatology professionals, this episode offers a clinical perspective on IBAT inhibitor therapy, persistent PBC-related itching, and the balance between symptom improvement and treatment tolerability.Clarifications and context within the video 👇Linerixibat, an IBAT inhibitor, is the first FDA approved treatment for cholestatic pruritus in adults with PBC.WI-NRS is used to assess itch severity on a scale of 0-10.At 6:43, correction regarding the diagnosis of cirrhosis: It was 10% in the placebo group and 11% in the linerixibat group.At 10:24, the primary endpoints of the LLSAT study are frequency and severity of adverse events.At 11:20, the LLSAT mean WI-NRS reduction of 4.87 is for patients assigned to linerixibat in GLISTEN Part A and Part B after 52 weeks of continuous treatment.

How can clinicians better recognize and manage itching and fatigue in primary biliary cholangitis (PBC)? In this podcast, hepatology clinicians from RUSH University Medical Center discuss the impact of PBC-related pruritus and fatigue on sleep, daily activities, and quality of life. The conversation explores proactive symptom screening, assessing itch severity, and individualizing treatment with options such as cholestyramine, PPAR therapies, rifampin, and sertraline. The speakers discuss how their treatment approaches have evolved and why ongoing communication helps identify when symptom management needs to change. For patients experiencing PBC fatigue, they address evaluating contributing factors such as thyroid dysfunction, vitamin D deficiency, and anemia, along with sleep hygiene, exercise, and realistic expectations for treatment. Throughout the discussion, they emphasize that symptom severity does not necessarily reflect liver disease progression or biochemical response. This episode highlights the importance of looking beyond liver tests, validating patients’ experiences, and encouraging patient advocacy and support networks as part of comprehensive PBC care.

In this episode, HoChong Gilles of the Richmond VA Medical Center, and Alison Moe of Atlanta Gastroenterology discuss a practical, step-by-step approach to screening for and diagnosing cholestatic liver disease. The conversation reviews how to recognize a cholestatic liver test pattern, evaluate symptoms such as pruritus and jaundice, and confirm that an elevated alkaline phosphatase is hepatic in origin through fractionation and gamma-glutamyl transferase (GGT) testing. The experts explain how clinical history, medication and supplement use, laboratory findings, and imaging can help distinguish intrahepatic cholestasis from extrahepatic biliary obstruction. They also examine the roles of ultrasound, MRI/MRCP, endoscopic ultrasound, and ERCP when evaluating bile duct dilation, strictures, gallstones, primary sclerosing cholangitis, and possible malignancy. Additional topics include autoimmune testing for conditions such as primary biliary cholangitis, the importance of considering drug-induced liver injury and herbal supplements, and when a liver biopsy may be appropriate after a comprehensive noninvasive workup. This educational podcast provides gastroenterology and hepatology clinicians, advanced practice providers, and other healthcare professionals with a clear clinical framework for evaluating abnormal liver tests and identifying the underlying cause of cholestasis.

Thank you to Salix for their support on this podcast episode. In this GHAPP podcast, host Christina Hanson, FNP, welcomes Janet Gripshover, DNP, FNP-BC, MBA, for a practical discussion on recognizing and managing overt hepatic encephalopathy (OHE) in patients with chronic liver disease and cirrhosis. The episode reviews how liver disease may progress from fibrosis to compensated and decompensated cirrhosis, where OHE can emerge as a serious complication. Christina and Janet highlight early signs that may be easy to overlook, including sleep-wake reversal, forgetfulness, personality changes, difficulty concentrating, slowed or slurred speech, balance problems, and challenges completing familiar daily activities.Drawing on real-world patient scenarios, they discuss common OHE triggers and risk factors, including infection, gastrointestinal bleeding, constipation, dehydration, electrolyte imbalances, prolonged fasting, sedating medications, portosystemic shunting, and sarcopenia. The conversation also emphasizes that OHE is primarily a clinical diagnosis, the importance of involving family members and caregivers in symptom recognition, and the limited role of ammonia testing. Christina and Janet also review nutritional considerations, the use of FIB-4 in broader liver fibrosis assessment, timely follow-up, treatment adherence, and safety conversations surrounding driving, cooking, falls, and other daily activities. For more expert-driven GI and liver disease education, visit the GHAPP Digital Hub and GHAPP ACE app.

Thank you to Salix for their support on this FAQ video module.In this FAQ video module, Natalie Oliver, PA-C, discusses how healthcare professionals can counsel patients and caregivers about overt hepatic encephalopathy (OHE). This educational overview explains how cirrhosis and portal hypertension can reduce the liver’s ability to clear toxins from the blood, potentially leading to changes in thinking, behavior, and daily functioning. Viewers will learn how OHE may present through obvious symptoms—such as disorientation, slurred speech, or severe confusion—or through more subtle changes, including fatigue, irritability, difficulty concentrating, and trouble finding the right words.This video also highlights the importance of involving caregivers in symptom recognition while preserving patient autonomy, reviewing warning signs that require immediate medical attention, and reinforcing medication adherence through clear patient education. Natalie discusses additional counseling considerations, including avoiding sedating medications and constipation, supporting adequate protein intake and physical activity, and maintaining skeletal muscle mass. Ideal for gastroenterology and hepatology providers and advanced practice providers, this FAQ offers practical strategies for helping patients and families recognize OHE early and work collaboratively with the liver care team to manage this often-reversible complication. For more expert-driven GI and liver disease education, visit the GHAPP Digital Hub and GHAPP ACE app.