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This session explores the spectrum of HIV co-infections seen across Pacific Island Countries – tuberculosis, viral hepatitis and opportunistic infections – spanning both straightforward and complex clinical presentations. Combining two abstract presentations with a multi-country, case-based learning format, it emphasises practical diagnosis and management, community-based and continuity of care, and South-to-South learning across the Pacific. Cases are drawn from Kiribati, the Cook Islands, the Solomon Islands, Australia and Fiji, reflecting the diversity of settings and the shared challenges of the region.