The rising prevalence of opioid use disorder and injection drug use has resulted in an increasing incidence of chronic hepatitis C virus (HCV) infection. Although older adults historically have represented the bulk of HCV infections in the United States, demographics have shifted and most new infections are presenting in younger patients. As a result, screening guidelines for HCV have evolved, moving toward a near-universal screening paradigm. Rates of screening and linkage to care remain low, attributed to the fact that underserved populations are disproportionately affected and often have limited access to specialty care. Collaborative models to treat HCV using primary care providers have been proposed to facilitate linkage to care and reduce transmission.

Learning Objectives

• Review the epidemiology of viral hepatitis C
• Review appropriate screening, laboratory testing, and follow up for hepatitis C
• Review changes to treatment criteria and medication safety profiles based on the current Infectious Disease Society of America (IDSA) and American Association for the Study of Liver Disease (AASLD) guidelines
• Recognize examples of collaborative models for hepatitis C treatment and the importance of increasing treatment access in at-risk populations

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Approach to the Patient With a Palpable Breast Mass

Learning Objectives

• List the differential diagnoses of a palpable breast mass, including historical and physical examination features
• Describe the diagnostic evaluation of a patient with a palpable breast mass as well as breast imaging screening recommendations