40    SAJHIVMED   MARCH 2013, Vol. 14, No. 1  

CPD QUESTIONNAIRE
Vol. 14, No. 1

True (A) or false (B):

Regarding HIV-related lipodystrophy:
1.   The lipodystrophy syndrome is most commonly characterised 

by lipohypertrophy with lipomatosis. 
2.   In terms of the effect of antiretroviral therapy (ART) on 

lipodystrophy, an increase in trunk fat has been observed 
with efavirenz-, protease-inhibitor- and raltegravir-containing 
regimens, and a clear causal relationship has been established. 

3.   The metabolic complications of lipodystrophy are fully 
reversible through treatment modification.

Regarding partner concurrency and HIV:
4.   It is widely accepted that partner concurrency (having more 

than one sexual partner in a given period of time) is a major 
determinant of the spread of HIV in South Africa.

5.   Across South African language groups, multiple partners per 
year, point concurrency and lower condom utilisation rates 
are all associated with increased HIV prevalence by language 
group.

6.   The spread of HIV is driven by the degree of connectedness 
of the sexual network.

Regarding stavudine dosing:
7.   Obesity, female gender, age and duration of treatment 

are the risk factors increasing the possibility of severe 
hyperlactataemia and lactic acidosis when patients are on 
stavudine-containing ART regimens.

8.   Following a meta-analysis showing that lower doses of 
stavudine were safer and just as effective, the World Health 
Organization (WHO) issued a statement that only a low 
dose of stavudine (30 mg) should be used.

Regarding screening for HIV-associated neurocognitive 
disorders (HANDs):
9.     HANDs are commonly diagnosed by comparing neuro-

psychological scores with normative data using standard 
deviation as an indicator of impairment. 

10.   Using general scores from African samples is appropriate 
when placing people in categories of impairment using 
standard deviation from normative scores.

11.   Figures from South Africa suggest that up to 25% of HIV-
positive individuals may display cognitive impairment. 

Regarding adolescent HIV treatment services:
12.   The transition for young people living with HIV from 

paediatric/adolescent HIV healthcare providers to adult 
HIV healthcare providers is a major challenge. 

13.   A large number of healthcare programmes are tailored 
specifically for behaviourally infected adolescents and 
young adults with HIV in sub-Saharan Africa. This group 
represents one of the few demographic groups adequately 
served by the various healthcare systems.

14.   Adjusting to the concept of adult healthcare, adult-oriented 
clinic environments as well as a perceived sense of stigma 
are key challenges faced by young people transitioning into 
adult care services.

Regarding gender inequality in ART: 
15.   In African cohorts, women have higher mortality while 

receiving ART than men.
16.   Disproportionately more women than men have accessed 

ART in South Africa – 60 % of eligible women were receiving 
ART by mid-2011 compared with 40% of eligible men.

Regarding the prevention of mother-to-child transmission 
(PMTCT) of HIV:
17.   There is overwhelming global consensus that all HIV-

positive pregnant women should be started immediately 
on lifelong ART regardless of CD4 cell count.

18.   There is clear evidence that exposure to ART has no effect 
on pregnancy outcomes such as preterm delivery and low 
birth weight.

Regarding WHO guidelines for adult ART:
19.   WHO currently recommends that adults living with HIV 

start ART when their CD4 counts fall below 500 CD4 
cells/ µl.

20.   There are clear benefits to individual patient health 
associated with ART initiation above 350 cells/µl.

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Five CPD points are awarded for the correct completion and submission of the questions below.

CPD questionnaires must be completed online via www.cpdjournals.co.za. After submission, you can check the answers 
and print your certificate.

This programme is available free of charge to members of the SA HIV Clinicians Society and SAMA only.

INSTRUCTIONS
1. Read the journal. All the answers will be found there.
2. Go to www.cpdjournals.co.za to answer the questions.

Accreditation number: MDB001/011/01/2013 (Clinical)