Considerations in the Treatment of Opioid Use Disorder in Patients with HIV Infection and HIV/HCV Coinfection


CME Credit Available: 1.50 AMA PRA Category 1 Credits
Level: Advanced
Release Date: October 21, 2015
Date of Last Review/Update: May 21, 2019
Expiration Date: May 21, 2020

This Cases on the Web (COW) activity presents a case and 8 clinical decision points focusing on clinical considerations for initiation and maintenance of medications for opioid use disorder among people with HIV infection and HIV/HCV coinfection.

At each decision point, participants should select the option that they think is most sound and then read the presenters’ explanation of that option. Selecting the correct option links the participant to an extended discussion of the related medical findings, research-based evidence, and case management considerations.

To advance from one clinical decision point to the next, participants should click on the NEXT button located at the bottom of the page that discusses the best clinical option.

After reviewing the cases, participants may access the activity posttest and the course evaluation, both of which must be completed and submitted to claim continuing medical education (CME) credit or a certificate of participation or continuing education units (CEUs) or pharmacy credits. Please see the posttest and course evaluation for further instructions.

You may sample the activity without logging in by clicking the links in the sidebar. You must be logged in the entire time in order to claim CME credit for the activity.

Learning Objectives

On completion of this activity, learners will be able to:

  • Assess individuals with HIV infection or HIV/HCV coinfection for the presence and severity of opioid use disorder
  • Counsel patients on appropriate treatment options for opioid use disorder, focusing on medications for opioid use disorder
  • Describe potential drug interactions and monitoring parameters for patients receiving medications for opioid use disorder, HIV infection, or HCV infection

Assessment of Needs

The IAS–USA offers this state-of-the-art activity as part of a nationwide CME effort for physicians on the evolving challenges of managing HCV disease. This activity examines issues relevant to the management of medications for opioid use disorder in patients with HIV infection and HIV/HCV coinfection.

Intended Audience

This enduring material is designed for physicians who are actively involved in the medical care of people with HCV infection, specifically those who care for patients with HIV/HCV coinfection and opioid use disorder.

CME Information


The International Antiviral Society–USA (IAS–USA) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Credit Designation Statement

The IAS–USA designates this enduring material for a maximum of 1.50 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This CME activity is offered from May 21, 2019, to May 21, 2020. Physicians (MDs, DOs, and international equivalents) who successfully complete the activity posttest and submit the evaluation and registration forms are eligible to receive CME credit. Other health care practitioners will receive a Certificate of Participation.

Nursing Continuing Education Contact Hours

Educational Review Systems is an approved approver of continuing nursing education by the Alabama State Nursing Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Provider # 5-115. This program is approved for 1.5 hours of continuing nursing education.

Educational Review Systems is also approved for nursing continuing education by the state of California, the state of Florida and the District of Columbia.

Program expires May 21, 2020

Pharmacy Continuing Education Contact Hours

Educational Review Systems is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. This program is approved for 1.5 hours (0.15 CEUs) of continuing pharmacy education credit. Proof of participation will be posted to your NABP CPE profile within 4 to 6 weeks to participants who have successfully completed the posttest. Participants must participate in the entire presentation and complete the course evaluation to receive continuing pharmacy education credit.
UAN # 0761-9999-19-156-H02-P
Program expires May 21, 2020



Jeanette M. Tetrault, MD, FACP, FASAM
Dr Tetrault is Associate Professor of Medicine at Yale University School of Medicine and Director of the Addiction Medicine Fellowship Program. She is a fellow of the American College of Physicians and a diplomate of the American Board of Addiction Medicine. She is Co-Chair of the Addiction, Tobacco and Other Drug Use Interest Group at the Society of General Internal Medicine and is on the Board of Directors for the Addiction Medicine Fellowship Program Directors Association and the Addiction Medicine Foundation. She is a staff physician at a multispecialty drug treatment facility in New Haven, Connecticut. She oversees Screening, Brief Intervention, and Referral to Treatment training for internal medicine house staff and Yale Medical School students through funding from the Substance Abuse and Mental Health Services Administration (SAMHSA). Dr Tetrault is a clinician educator and focuses her scholarly and teaching activities on addiction and its associated comorbidities, namely HIV and hepatitis C virus (HCV) infections.

E. Jennifer Edelman, MD, MHS
Dr Edelman is Associate Professor at Yale School of Medicine. She serves as the Addiction Medicine Consultant at Yale-New Haven Hospital’s HIV clinic and conducts research focused on understanding and addressing substance use, including opioid use, among patients living with and at risk for HIV.

Acknowledgement to David A Fiellin, MD, for contributions to the original iteration of this Cases on the Web activity. Dr Fiellin is Professor of Medicine, Investigative Medicine, and Public Health at Yale University, and Director of the Community Research and Implementation Core at Yale Center for Interdisciplinary Research on AIDS.


R. Douglas Bruce, MD, MA, MSc
Dr Bruce is Chief of Medicine at Cornell Scott-Hill Health Center in New Haven, Connecticut. His scholarly work focuses on the intersection of addiction and infectious diseases, particularly HIV, hepatitis C, and tuberculosis. He has worked in the United States and abroad to improve health outcomes for marginalized populations through system-level changes and operations research to integrate various health-care delivery systems to improve access to and retention in clinical treatment.

Disclosure of Financial Interests

It is the policy of the IAS–USA to ensure balance, independence, objectivity, and scientific rigor in all its educational activities. All faculty members (planners, speakers, presenters, etc) participating in IAS–USA-sponsored activities are required to disclose to the program audience any financial relationships with commercial interests within the past 12 months that could be perceived to influence, or give the appearance of potentially influencing, the written or oral presentation. The Accreditation Council for Continuing Medical Education (ACCME) defines a financial interest as an interest in any amount and defines a commercial interest as “any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients. The ACCME does not consider providers of clinical service directly to patients to be commercial interests—unless the provider of clinical service is owned, or controlled by, an ACCME-defined commercial interest.” The information is intended to make the IAS–USA audience aware of speaker and contributor interests and commitments with commercial interests, enabling the audience members to form their own judgments about such associations.

Each author or contributor is required to complete this financial disclosure declaration. In accordance with IAS–USA policy, the IAS–USA will identify and resolve ahead of time any possible conflicts of interest that may influence CME activities with regard to exposition or conclusion. Financial relationship information about authors and editor is included here; information on the Cases on the Web Editorial Board can be found at


Dr Tetrault has no relevant financial affiliations to disclose. (Updated 03/20/19)
Dr Edelman has no relevant financial affiliations to disclose. (Updated 03/20/19)


Dr Bruce has no relevant financial affiliations to disclose. (Updated 02/06/19)

Grant Support

This activity is part of the IAS–USA national educational effort that is funded, in part, by charitable contributions from commercial companies. Per IAS–USA policy, any effort that uses commercial grants must receive grants from several companies with competing products. Funds are pooled and distributed to activities at the sole discretion of the IAS–USA. Grantors have no input into any activity, including its content, development, or selection of topics or speakers. Generous support for this activity has been received from the following contributors.

2019 Grant Support for the IAS-USA HIV national CME effort:

Platinum Supporters
Gilead Sciences, Inc
Merck & Co, Inc
ViiV Healthcare

Additional support provided by Janssen Therapeutics

Cases on the Web Editorial Board

Members of the COW Editorial Board participate in a volunteer capacity. They are not compensated for their role in overseeing the program. Listed below are the COW Editorial Board members and their financial interests with commercial companies within the past 12 months from the date of disclosure. Click here to view the COW Editorial Board.

Drug and Product Disclaimer

This activity may contain information about the investigational uses of drugs or products that are not approved by the US Food and Drug Administration. Please consult full prescribing information before using any medication or product mentioned in this COW activity.

The views and opinions expressed herein are those of the faculty and do not necessarily represent the opinions or recommendations of the IAS–USA.

Contact Information

If you have any questions about this COW activity, please contact the IAS–USA:

131 Steuart St
Ste 500
San Francisco, CA 94105
Telephone: (415) 544-9400

Course Content