You are leaving Medscape Education
Cancel Continue
Log in to save activities Your saved activities will show here so that you can easily access them whenever you're ready. Log in here CME & Education Log in to keep track of your credits.
 

CPD

HIV: Complex Case Study Library Extension

  • Authors: Santiago Moreno, MD, PhD
  • CPD Released: 4/13/2022
  • Valid for credit through: 4/13/2023
Start Activity

  • Credits Available

    Non-US Physicians - maximum of 1.00 CPD

    You Are Eligible For

    • Letter of Completion

Target Audience and Goal Statement

This educational activity is intended for an international audience of non-US HIV specialists, primary care physicians, and hematology/oncology specialists.

The goal of this activity is for clinicians to be able to manage patients with difficult-to-treat HIV.

Upon completion of this activity, participants will:

  • Have greater competence related to
    • Using best practices in the management of complex cases


Disclosures

WebMD Global requires every individual in a position to control educational content to disclose all financial relationships with ineligible companies that have occurred within the past 24 months. Ineligible companies are organizations whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships with ineligible companies.


Faculty

  • Santiago Moreno, MD, PhD

    Head
    Department of Infectious Diseases
    Hospital Ramón y Cajal
    Madrid, Spain

    Disclosures

    Consultant or advisor for: Gilead; GlaxoSmithKline; Janssen; Merck; Pfizer; SOBI; ViiV Healthcare
    Speaker or member of speakers bureau for: Gilead; GlaxoSmithKline; Janssen; Merck; Pfizer; SOBI; ViiV Healthcare
    Research funding from: Gilead; ViiV Healthcare
    Contracted researcher for: Gilead; GlaxoSmithKline; Janssen; Merck; Pfizer; SOBI; ViiV Healthcare

Editors

  • Shanthi Voorn, PhD

    Medical Education Director, WebMD Global, LLC

    Disclosures

    Disclosure: Shanthi Voorn, PhD, has no relevant financial relationships.

  • Jenny Engelmoer, PhD

    Medical Writer, Sula Communications, The Netherlands

    Disclosures

    Disclosure: Jenny Engelmoer, PhD, has no relevant financial relationships.

Compliance Reviewer

  • Susan L. Smith, MN, PhD

    Associate Director, Accreditation and Compliance

    Disclosures

    Disclosure: Susan L. Smith, MN, PhD, has no relevant financial relationships.

Peer Reviewer

This activity has been peer reviewed and the reviewer has no relevant financial relationships.


Accreditation Statements

    For Physicians

  • The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.0 continuing professional development credits (CPD).

    Contact WebMD Global

For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact [email protected]


Instructions for Participation and Credit

There are no fees for participating in or receiving credit for this online educational activity. For information about your eligibility to claim credit, please consult your professional licensing board.

This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent participating in the activity. To successfully earn credit, participants must complete the activity online during the credit eligibility period that is noted on the title page.

Follow these steps to claim a credit certificate for completing this activity:

  1. Read the information provided on the title page regarding the target audience, learning objectives, and author disclosures, read and study the activity content and then complete the post-test questions. If you earn a passing score on the post-test and we have determined based on your registration profile that you may be eligible to claim CPD credit for completing this activity, we will issue you a CPD credit certificate.
  2. Once your CPD credit certificate has been issued, you may view and print the certificate from your CME/CE Tracker. CPD credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of the Medscape Education homepage.

We encourage you to complete an Activity Evaluation to provide feedback for future programming.

You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.

*The credit that you receive is based on your user profile.

CPD

HIV: Complex Case Study Library Extension

Authors: Santiago Moreno, MD, PhDFaculty and Disclosures

CPD Released: 4/13/2022

Valid for credit through: 4/13/2023

processing....

The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.

CLINICAL CASE 1: PATIENT HISTORY

The first patient in this case series is a 52-year-old woman who was diagnosed with HIV in December 1999. At diagnosis, her CD4+ count was 62 cells/µL and HIV RNA was 200,000 copies/mL. She had no history of opportunistic infections at diagnosis. Her treatment history and reasons for switch are outlined in Table 1.

Table 1. Patient Treatment History and Reasons for Switch for Case 1

From

To

Regimen

Reason for Switch

December 1999

February 2001

D4T + 3TC + NVP

Virological failure

February 2001

August 2001

ZDV/3TC + NVP

Virological failure

August 2001

January 2002

ZDV/3TC/ABC

Virological failure

January 2002

January 2004

ZDV/3TC/ABC + TDF

Virological failure

January 2004

January 2009

TDF/3TC/EFV

Virological failure

January 2009

June 2010

DRV + MVC + RAL

Virological failure

June 2010

January 2013

ETR + MVC + RAL

Virological failure

January 2013

April 2013

No therapy

Virological failure

April 2013

November 2015

3TC

Virological failure

3TC, lamivudine; ABC, abacavir; D4T, stavudine; DRV, darunavir; EFV, efavirenz; ETR, etravirine; MVC, maraviroc; NVP, nevirapine; RAL, raltegravir; TDF, tenofovir disoproxil fumarate; ZDV, zidovudine.

On referral to the clinic, the patient had a viral load of 50,000 copies/mL and CD4+ count of 167 cells/µL. Her body weight was 61 kg, blood pressure was 120/88 mm Hg, heart rate was 74 beats per minute (bpm), and respiratory rate was 16 respirations per minute (rpm). Kidney and liver function tests were normal, and her fasting blood glucose was 4.5 mmol/L. A physical examination recorded no abnormal findings.

The patient had reported no adverse reactions to any of the drugs in her treatment history except for the development of lipoatrophy following treatment with zidovudine (ZDV) and stavudine (D4T).

  • Print