VIRTUAL MEDZONEYour Resource for HIV Related Innovative Medical Communication

HIV CASE PRESENTATIONS

Anita Rachlis MD FRCPCKen Logue MD David Fletcher MD FRCPC

CASE 1

• 49 yo man• HIV+ 1986• CD4 400 • Asymptomatic

CASE 1

DATE REGIMEN CD4 VL1996 AZT/3TC/INDINAVIR 120 ?

1996-99 D4T/3TC/RTV/SQV 200/10% 13,000- 32000

CASE 1

DATE REGIMEN CD4 VL

1996-99 D4T/3TC/ RTV/SQV

200/10% 13000- 32000

1999- 2003

ABC/DDI/ RTV/LPV/NVP

200-350/14% 1000- 3000

CASE 1

GENOTYPEMAR/03

CASE 1

DATE REGIMEN CD4 VL1999- 2003

ABC/DDI/ RTV/LPV/NVP

200-350/14% 1000- 3000

2003-08 ABC/DDI/RTV/ LPV/APV/ NVP/T20

350-530/16% <50

2008-11 ABC/3TC/RTV/ DRV/RGV/NVP

(bid)

370-420/18% <50

CASE 1

APRIL 2011• Patient informs physician of OD pill

taking for the last year despite a bid script!!!!

• ABC/3TC/ ½ dose RTV/DRV/RGV/NVP• Despite this…HIV Viral Load<39!!!

WHAT WOULD YOU DO?

CASE 1

GENOTYPEMAR/03

CASE 1

• OD ABC/3TC/RTV 100mg/DRV 1200mg/RGV 800 mg/ETV 400mg

?Role Of OD DRV?Role of Etravirine?Role of TDF/FTC

?Role of Maraviroc

CASE 1

• 49 yo man• HIV+ 1986• CD4 400 • Asymptomatic

CASE 1

• 49 yo man• HIV+ 1986• CD4 400 • Asymptomatic

CASE 1

• 49 yo man• HIV+ 1986• CD4 400 • Asymptomatic