Here we provide you with cases published in the HIV/TB Drug Resistance & Clinical Management Case Book. These cases have been presented to over 1000 medical doctors in southern Africa at the annual SATuRN Drug Resistance Workshops.
The objective is to capacitate doctors, nurses and allied medical staff at all levels of the health system to prevent and manage HIV and TB drug resistance.
Authors: Richard Lessells, Theresa Rossouw & Tulio de Oliveira
This 39 year old female patient was diagnosed with HIV infection during pregnancy in 2007 and received sdNVP at the time of delivery. She had a CD4 cell count <200cells/ul in January 2008 but did not start antiretroviral therapy. She initiated TDF/3TC/EFV in September 2010.
Adherence to clinic visits has been good according to her file: she attended on time for each clinic visit. She knows the names and dosages of her antiretrovirals. She has disclosed her HIV status and ART use to family members. Counselling has not revealed any specific barriers to adherence.
Clinical chart:The patient had suboptimal viral suppression at six months after ART initiation and has remained viraemic at 12 months. There was some immunological response with increase of CD4+ cell count from 96cells/ul at baseline to 171cells/ul at six months.