FORUM

Clinical case study programme

Regina Osih, MD, MPH

Corresponding author: R Osih (regina.osih@gmail.com)

The Southern African HIV Clinicians Society’s online clinical cases are geared at providing excellent continuing medical education for members of the Society. This activity has been created to offer clinicians working in the HIV area access to online education. Cases are written by experienced HIV specialists and can range from general adult HIV/TB through specialist paediatric cases to other related infectious diseases encountered when managing patients with HIV.

Cases can be marked with one, two or three stars. One-star cases are basic cases directed towards clinicians who are new to the practice of HIV or who intend to start providing HIV care. They are also appropriate for clinicians who have more experience but who do not see HIV-positive patients on a routine basis and would like to refresh their knowledge around the management of key HIV-related conditions.

Cases marked with two stars are meant for clinicians who work daily with HIV-positive patients but would not consider themselves experts in the field. Cases marked with three stars are meant for clinicians who currently provide comprehensive HIV care and/or are specialists in the field of HIV and infectious disease. Each activity is accredited for four CPD points through the Health Professions Council of South Africa. While the activity is open to all users of the website, only members of the Society can redeem CPD points for successfully completing the activity.

Box 1 provides an abbreviated example of a case from the case library. This particular case illustrates the complex interaction between viral hepatitis B and HIV in mode of transmission, diagnosis and treatment. It also explores reasons why an HIV-1 viral load could be below the level of detection in this patient, or in an untreated patient in general. Other case studies focus on ART complications, paediatric HIV treatment and ethical issues. Case studies will be added on a regular basis to form a library of resources available to all Society members.

For more information, please visit our website case library at http://www. sahivsoc.org/case-studies/overview.

Regina Osih is a public health consultant in private practice in Johannesburg.

Box 1. Summary of clinical case study:

Hepatitis B

A 24-year-old man presents to the clinic with a history of hepatitis B, treated at another hospital a year go. He had presented with acute hepatitis a few years ago, and on follow-up at 6 months was found to be hepatitis BsAg positive and treated for 1 year with 3TC (lamivudine). He presents to a new clinic after 1 year of 3TC treatment (which has just been discontinued) for further management. This patient was not tested for HIV at the time of his first presentation. An HIV test is done at this presentation, and it is positive – but with an undetectable HIV-1 viral load.