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A maximum of 3 CEUs will be awarded per correctly completed test.

CPD questionnaires must be completed online at www.mpconsulting.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.mpconsulting.co.za to answer the questions.

Accreditation number: MDB001/012/01/2014 (Clinical)

CPD QUESTIONNAIRE
December 2014 Vol. 15, No. 4

160    DECEMBER 2014, Vol. 15, No. 4   SAJHIVMED

1.    Currently, there are six classes of antiretroviral agents 
available in South Africa.

2.    Integrase inhibitors prevent the assembly and maturation of 
infectious viral progeny.

3.    There is definitive evidence that patients with CD4+ 
>500 cells/uL should initiate antiretroviral therapy (ART) 
for their own health.

4.    In patients with tuberculosis, ART initiation may be delayed 
by up to 8 weeks to reduce the risk of immune reconstitution 
inflammatory syndrome (IRIS).

5.    In patients with cryptococcal meningitis, ART initiation 
should not be delayed by more than 2 weeks after initiation 
of antifungal therapy, to reduce the risk of mortality.

6.    In an otherwise stable patient on efavirenz 600 mg once a day 
who has significant non-reversing central nervous system 
side-effects, dose reduction to 400 mg once a day may be a 
viable strategy to maintain viral suppression while reducing 
side-effects.

7.    Any detectable viral load (e.g. above 50 copies/mL) 
is significant and requires interventions to improve 
adherence.

8.    In stable patients with suppressed viral loads and CD4+ 
>200 cells/uL, it may be possible to stop CD4+ monitoring 
as it adds little to clinical management.

9.    In patients who are seroconverting (newly infected with 
HIV), immediate ART initiation may be associated with 
improved viral control and long-term health outcomes.

10.  If HIV diagnosis is made using rapid tests outside of 
the laboratory, confirmation of HIV infection using 
a laboratory-based test (viral load or enzyme-linked 
immunosorbent assay (ELISA)) is advised before ART 
initiation to rule out false positive rapid-test results. 

11.  Atazanavir may be preferred to lopinavir as the protease 
inhibitor of choice because it has a lower gastrointestinal 
and blood lipid side-effect profile, and does not require 
boosting with ritonavir. 

12.  In a patient who reinitiates ART after stopping therapy, 
the first viral load testing should ideally take place 6 - 
12 months after reinitiation.

13.  For patients with liver impairment, a regimen of tenofovir, 
lamivudine (or emtracitibine) and raltegravir is considered 
the least hepatotoxic. 

14.  There are few drug-drug interactions between antiretrovirals 
and antimalarial drugs.

15.  Surgeons’ use of two surgical gloves (‘double-gloving’) is 
unlikely to be useful in preventing exposure to blood-borne 
pathogens. 

16.  Surgeons may be least likely to experience intraoperative 
glove puncture when the patient is known to be HIV-
positive.

17.  Talaromyces marneffei is a common AIDS-defining 
opportunistic infection in South-east Asia and central 
Africa, which may resemble disseminated tuberculosis, and 
which is sensitive to fluconazole.

18.  Deep fungal infections in HIV-infected patients commonly 
present with fever, weight loss, skin papules with central 
necrosis, respiratory involvement, lymphadenopathy and 
hepatosplenomegaly. 

19.  While possible to down-refer HIV-infected children on ART 
from tertiary or secondary hospitals to primary healthcare 
facilities, their outcomes are generally not as good as those of 
children kept in hospital-based, specialist paediatrician care.

20.  For children initiating ART, mortality is lower in infants 
compared with older children.

True or False: