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Please read this page before participating in this activity. At the bottom of the page, select “I have read these instructions and understand them,” and then click “Begin Activity.”
CME Credit Available: 1 AMA PRA Category 1 CreditTM
Release Date: December 22, 2008
Date of Last Review/Update: January 26, 2010
Expiration Date: December 22, 2010
This Cases on the Web activity introduces a case and presents 6 clinical decision points, each focusing on the comprehensive initial evaluation of a patient with a new HIV diagnosis. At each clinical decision point, learners should select the option that they believe is most sound and then read the presenters’ explanation of that option. Choosing the correct option links the learner to an extended discussion of related medical findings, research-based evidence, and case management considerations.
To advance from one clinical decision point to the next, learners should click on the NEXT arrow at the base of each page that discusses the best clinical option.
After reviewing the case, learners may link to the continuing medical education (CME) post test questions and the course evaluation, both of which must be completed and submitted to receive credit. Please see the post test form and the evaluation form for further instructions.
On completion of this activity, the learner will be able to:
- Prioritize the initial evaluation and management considerations for a patient with a new HIV diagnosis.
- Identify the relevant aspects of the medical history of patients in this population.
- List the organ systems requiring attention on physical examination in the asymptomatic patient with HIV infection.
- List the diagnostic and screening tests that should be part of the initial evaluation of an HIV-infected patient.
- Choose appropriate antimicrobial prophylaxis for opportunistic infections on the basis of the patient’s baseline CD4+ cell count.
- Identify necessary and contraindicated immunizations in this patient population.
The International AIDS Society–USA offers this state-of-the-art activity as part of a nationwide CME effort for HIV physicians on the evolving challenges of HIV disease. This activity examines issues relevant to performing a comprehensive initial evaluation of a patient with a new HIV diagnosis.
This Cases on the Web presentation is part of a series of basic-level CME activities designed for physicians who are:
- New to the practice of HIV medicine or who intend to start providing care for patients with HIV and AIDS.
- Seeking to refresh their understanding of the standard elements of HIV care.
This activity is also relevant to nurse practitioners, physician assistants, nurses, and other health professionals who are new to HIV care or who wish to refresh their understanding of the standard elements of HIV care.
The International AIDS Society–USA is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.
The International AIDS Society–USA designates this educational activity for a maximum of 1 AMA PRA Category 1 CreditTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.
This CME activity is offered from December 22, 2009 to December 22, 2010. Participants who successfully complete the activity posttest and submit the evaluation and registration forms are eligible to receive CME credit. Physicians (MDs, DOs, and international equivalents) may receive CME credit for completing this activity. Nonphysician health care practitioners will receive a certificate of attendance.
Authors
Michael Melia, MD
Dr Melia is instructor in medicine and staff physician in the Department of Medicine, Division of Infectious Diseases at the Johns Hopkins University School of Medicine in Baltimore, Maryland. His clinical and research interests include inpatient and outpatient general infectious disease consultations, HIV infection, and viral hepatitis.
Howard Libman, MD
Dr Libman is professor of medicine at Harvard Medical School and director of the HIV program in Healthcare Associates at Beth Israel Deaconess Medical Center in Boston, Massachusetts. Dr Libman is coeditor of the textbook, HIV, 3rd edition, published in 2007 by the American College of Physicians. He is a member of the Infectious Diseases Society of America national expert panel on HIV primary care guidelines.
Editor
Judith A. Aberg, MD
Dr Aberg is associate professor of medicine at New York University (NYU) and the director of virology at Bellevue Hospital Center, New York. She serves as the principal investigator for the NYU AIDS Clinical Trials Unit and on the editorial boards of several clinical journals. She is an attending physician in infectious diseases and virology.
In the interest of maintaining the independence of its continuing medical education activities, and in accordance with the policies of the Accreditation Council for Continuing Medical Education, the International AIDS Society–USA requires all persons with control of content (eg; authors, reviewers, Editorial Board members, and the staff of the Cases on the Web program) to disclose any financial interests that they (or their spouses or partners) have with commercial companies within the past 12 months.
Faculty
2010 Update
Dr Melia has been a member of the scientific advisory board for Tibotec Therapeutics.
2008 Release
Dr Melia and Dr Libman have no relevant financial relationships to disclose.
Dr Aberg has served as a consultant for Abbott Laboratories, Boehringer Ingelheim Pharmaceuticals, Inc, Bristol-Myers Squibb, Gilead Sciences, Inc, GlaxoSmithKline, and Tibotec Therapeutics. She has received grants or research support from Abbott Laboratories, Bristol-Myers Squibb, Merck & Co, Inc, and Pfizer Inc and was a paid lecturer for Abbott Laboratories and Bristol-Myers Squibb. Dr Aberg has received fees for written enduring materials, internet activities, or audio activities from Abbott Laboratories and Bristol-Myers Squibb.
Cases on the Web Editorial Board
The members of the Cases on the Web (COW) Editorial Board are volunteers and are not compensated for their role in overseeing the program. Listed below are the COW Editorial Board members and their financial interests with commercial companies within the past 12 months from the date of disclosure.
Michael S. Saag, MD — Editor-in-Chief Professor of Medicine The University of Alabama at Birmingham
Dr Saag has received grants and research support from and has been a scientific advisor to Ardea Biosciences, Inc, Avexa Ltd, Boehringer Ingelheim Pharmaceuticals, Inc, Bristol-Myers Squibb, Gilead Sciences, Inc, GlaxoSmithKline, Merck & Co, Inc, Monogram Biosciences, Inc, Pain Therapeutics, Inc, Pfizer Inc, Progenics Pharmaceuticals, Inc, Tibotec Therapeutics, and Tobira Therapeutics. (Updated 08/10/10)
Marshall J. Glesby, MD, PhD — Coeditor Associate Professor of Medicine and Public Health Weill Medical College of Cornell University
Dr Glesby has no relevant financial interests to disclose. (Updated 09/01/09)
Judith A. Aberg, MD Associate Professor of Medicine
New York University School of Medicine
Dr Aberg has been a scientific advisor to Gilead Sciences, Inc, Merck & Co, Inc, Tibotec Therapeutics and ViiV Healthcare. She participates in multicenter clinical trials from Gilead Sciences, Inc, GlaxoSmithKline, Merck & Co, Inc, Pfizer Inc, Schering-Plough Corp, Theratechnologies Inc, and Tibotec Therapeutics. Dr Aberg currently holds nonsalaried contracts for pending multicenter clinical trials with Adamas Pharmaceuticals, Inc, and Wyeth Pharmaceuticals. (Updated 03/25/10)
Roger J. Bedimo, MD, MS Director, Infectious Disease Fellowship Training
University of Texas Southwestern Medical Center
Dr Bedimo has been a scientific advisor to Abbott Laboratories, Merck & Co, Inc, and Tibotec Therapeutics. He has received grants and research support from Abbott Laboratories, Merck & Co, Inc, and Tibotec Therapeutics. (Updated 10/08/09)
Meg D. Newman, MD Associate Professor of Medicine
University of California San Francisco
Dr Newman has no relevant financial interests to disclose. (Updated 09/01/09)
Paul E. Sax, MD Associate Professor of Medicine
Harvard Medical School
Dr Sax received grants and research support from GlaxoSmithKline, Merck & Co, Inc, and Tibotec Therapeutics. He served as a consultant to or contributed to CME program materials for Abbott Laboratories, Bristol-Myers Squibb, Gilead Sciences, Inc, GlaxoSmithKline, Merck & Co, Inc, Pfizer Inc, and Tibotec Therapeutics. (Updated 09/14/09)
Staff of the Cases on the Web
Donna M. Jacobsen — Executive Director/President
Ms Jacobsen has no relevant financial affiliations to disclose. (Updated 08/12/10)
IAS–USA Board of Directors
The nonstaff members of the IAS–USA Board of Directors participate in a volunteer capacity. They are not compensated for their roles in governing/overseeing the IAS–USA. Listed below are the IAS–USA Board of Directors and their financial interests with commercial companies within the last 12 months from the date of disclosure.
Constance A. Benson, MD Professor of Medicine University of California San Diego
Dr Benson has received research grants awarded to the University of California San Diego from Gilead Sciences, Inc. She has served on scientific advisory boards for GlaxoSmithKline, ViiV Healthcare, and Merck & Co, Inc, and has chaired a data and safety monitoring board for Achillion Pharmaceuticals, Inc. (Updated 08/09/10)
Judith S. Currier, MD Professor of Medicine University of California Los Angeles
Dr Currier has received research grants awarded to the University of California Los Angeles from Merck & Co, Inc, and Schering-Plough Corp. (Updated 08/11/10)
Carlos del Rio, MD Professor of Medicine Emory University
Dr del Rio has received research grants awarded to Emory University from Merck & Co, Inc, Schering-Plough Corp, and Sanofi Pasteur. (Updated 08/10/10)
Joel E. Gallant, MD, MPH Professor of Medicine and Epidemiology The Johns Hopkins University
Dr Gallant has served as a consultant to Abbott Laboratories. He has been a member of data and safety monitoring boards and endpoint adjudication committees for Gilead Sciences, Inc, and Sangamo Biosciences, Inc. He has been a member of scientific or clinical advisory boards for Bristol-Myers Squibb, Gilead Sciences, Inc, Merck & Co, Inc, Tibotec Therapeutics, and ViiV Healthcare. Johns Hopkins University has been the recipient of research grants or contracts from Gilead Sciences, Inc, for research conducted by Dr Gallant. (Updated 08/10/10)
Roy M. Gulick, MD, MPH Professor of Medicine Weill Medical College of Cornell University
Dr Gulick has served as a consultant to Bristol-Myers Squibb, Gilead Sciences, Inc, MedImmune, LLC, ViiV Healthcare, and ViroStatics and as an investigator for research study grants (to Weill Cornell) from Pfizer Inc, Schering-Plough Corp, and Tibotec Therapeutics. (Updated 08/10/10)
Douglas D. Richman, MD Professor of Pathology and Medicine University of California San Diego
Dr Richman has been a consultant to Biota, Bristol-Myers Squibb, CHIMERx, Gen-Probe Inc, Gilead Sciences, Inc, Idenix Pharmaceuticals, Inc, Merck & Co, Inc, Monogram Biosciences, Inc, Myriad Genetics, Inc, and Theraclone Sciences. He has been on an endpoint adjudication committee for Schering-Plough Corp and has been the recipient of research grants or contracts from Merck & Co, Inc. Dr Richman has been a stock options holder of CHIMERx and Idenix Pharmaceuticals, Inc, and a stock shareholder of Monogram Biosciences, Inc. (Updated 08/09/10)
Michael S. Saag, MD — Editor-in-Chief Professor of Medicine The University of Alabama at Birmingham
Dr Saag has received grants and research support from and has been a scientific advisor to Ardea Biosciences, Inc, Avexa Ltd, Boehringer Ingelheim Pharmaceuticals, Inc, Bristol-Myers Squibb, Gilead Sciences, Inc, GlaxoSmithKline, Merck & Co, Inc, Monogram Biosciences, Inc, Pain Therapeutics, Inc, Pfizer Inc, Progenics Pharmaceuticals, Inc, Tibotec Therapeutics, and Tobira Therapeutics. (Updated 08/10/10)
Robert T. Schooley, MD Professor of Medicine University of California San Diego
Dr Schooley has served as a consultant to Achillion Pharmaceuticals, Inc, Gilead Sciences, Inc, Inhibitex, Inc, Johnson & Johnson Services, Inc, Tobira Therapeutics, and Laboratory Corporation of America. He has stock options for Achillion Pharmaceuticals, Inc. (Updated 08/10/10)
Paul A. Volberding, MD Marvin Sleisenger Professor of Medicine Vice-Chair, Department of Medicine University of California San Francisco
Dr Volberding has served on data and safety monitoring boards for Merck & Co, Inc, and TaiMed Biologics, and on an endpoint adjudication committee for Schering-Plough Corp. He has served on scientific or clinical advisory boards for Bristol-Myers Squibb, Gilead Sciences, Inc, Pfizer Inc, and Tobira Therapeutics. (Updated 08/10/10)
This Cases on the Web activity is sponsored by the International AIDS Society–USA and was made possible through educational grants from the following commercial companies.
January 2010 Update
The following funders support Cases on the Web as part of the International AIDS Society–USA 2010 national continuing medical education effort:
Substantial Grant Support
Tibotec Therapeutics
Merck & Co, Inc
Bristol-Myers Squibb
Gilead Sciences
Generous Grant Support
ViiV Healthcare
Additional support for Cases on the Web specifically is provided by:
Boehringer Ingelheim Pharmaceuticals, Inc
Abbott Laboratories
December 2009 Update
Substantial Grant Support
Bristol-Myers Squibb
Gilead Sciences
Merck & Co, Inc
Pfizer Global Pharmaceuticals
Tibotec Therapeutics
Generous Grant Support
GlaxoSmithKline
Additional Grant Support
Roche Laboratories
December 2008 Release
Substantial Grant Support
Bristol-Myers Squibb
Tibotec Therapeutics
Abbott Laboratories
Gilead Sciences
Merck & Co, Inc
Pfizer Global Pharmaceuticals
Generous Grant Support
GlaxoSmithKline
This activity may contain information about the investigational uses of drugs or products that are not approved by the US Food and Drug Administration. Please consult full prescribing information before using any medication or product mentioned in Cases on the Web.
The views and opinions expressed herein are those of the faculty and do not necessarily represent the opinions or recommendations of the International AIDS Society–USA.
If you have any questions about this Cases on the Web activity, please contact the International AIDS Society–USA:
International AIDS Society–USA
425 California Street
Suite 1450
San Francisco, CA 94104-2120
Telephone: 415-544-9400
Fax: 415-544-9401
E-mail: info2009"at"iasusa.org
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