Archive | Case of the Month

Every month, we highlight a case that represents current questions from our clinician consultations.

Case of the Month: ARVs and Dizziness

Case Summary A physician calls the CCC HIV/AIDS Management Service about a 33-year-old HIV-positive man whose occupation requires going to extreme heights. The patient is treatment-naive and has a high CD4 count with a viral load of 13,000 copies/mL. His genotype showed a wild-type virus. The caller inquires what antiretroviral medications should be considered for […]

Case of the Month: Pediatric ARV Regimen Selection

Case Summary A pediatrician calls the CCC about a three-year-old HIV-positive boy recently adopted from Ethiopia who recently immigrated to the U.S. His adoptive parents told the pediatrician that they’d received zidovudine/lamuvudine/nevirapine bottles from the orphanage, but are unclear as to whether the boy was regularly receiving antiretrovirals (ARVs). Currently, the child is not taking […]

Case of the Month: Initiating PrEP and Providing Appropriate Follow-Up

Case Summary A family physician calls about a 19-year-old bisexual man interested in pre-exposure prophylaxis (PrEP). The patient is HIV-negative. He has multiple partners and uses protection, but not regularly. The patient is currently not on post-exposure prophylaxis (PEP), has no signs compatible with acute HIV, and has normal renal and hepatic function. What is […]

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Case of the Month: Pending HIV Test Results and Labor

Case Summary A pediatrician asked about a Gravida 3, Para 1 woman (age unknown) at 39 weeks gestation who was admitted for induction of labor due to gestational diabetes mellitus. The woman‘s male partner of 12 years was HIV+ and taking antiretroviral medications with an undetectable viral load. The patient reported that her last sexual […]

Case of the Month: HIV Treatment in Sero-Discordant Couples

Case Summary A family medicine clinician called about a 62-year-old man who was a new patient. As part of standard intake, the clinician sent off a routine HIV screen, which came back positive for HIV-1 antibodies. The patient told the clinician that he knew of his status already and that he had initially been diagnosed […]

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Case of the Month: Using PEP to Manage Sexual Exposure

Case Summary A family physician called the CCC about a male patient who had been in a monogamous relationship with another man for the past four months. The patient had had multiple sexual exposures with this partner, the most recent exposure taking place 72 hours before the consultation call. Could this patient be a candidate […]

Case of the Month: Indeterminate Results and Repeat HIV Testing

Case Summary A gynecologist asked about a 30 year-old female patient who had a positive HIV1 and HIV2 antibody screen and a negative Western Blot test. The patient had undergone testing during routine preconception labs. She did not want to wait six months to retest to rule out early HIV infection not adequately excluded by […]

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Case of the Month Special Edition: Hepatitis C and the Risk of Treatment Failure

In honor of National Hepatitis Awareness Month, the CCC is sharing a case from its CCC VA Hepline. The Hepline is currently a service for medical providers at U.S. Department of Veterans Affairs institutions and clinics only. Case Summary An infectious disease clinician called about a 44-year-old patient with a history of injection drug use […]

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Case of the Month: Diabetes and ARV Selection

Case Summary A doctor asked about a 48-year-old African-American male who had been diagnosed with HIV in 2001. The patient is currently taking an abacavir/lamivudine combo pill, tenofovir, atazanavir, and ritonavir. The patient’s mutations included M184V and KI103N. The patient’s CD4 count was 560, with an undetectable viral load. The patient had recently been diagnosed […]

Case of the Month: Possible False Positive HIV Test

Case Summary A physician called about HIV screening for a 38-year-old man who wanted to be tested because he was getting married and had a history of injection drug use. He had been sober for 2 years at the time of the screening test. The patient had initially had a 4th generation HIV test that […]