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Working with HIV CASE PRESENTATIONS: SARAH BARBER CNS HIV. 01689 866647.

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Presentation on theme: "Working with HIV CASE PRESENTATIONS: SARAH BARBER CNS HIV. 01689 866647."— Presentation transcript:

1 working with HIV CASE PRESENTATIONS: SARAH BARBER CNS HIV

2 working with PATIENT A 36 year old Black African male Lives in Anerley, originally from Ivory Coast – in UK for 5 years refuse collector married with a 4 year old child

3 working with PC AND PMH weight loss (May 2010) fatigue back pain (? occupational) headache (2009) knee problems (2008) registered (2005)

4 working with RESULTS and ACTION HIV +ve and Hep B +ve Referred GUM (June 2010) Results confirmed o/e nil specific but self reports fatigue and wt loss CD4 100 and viral load !

5 working with TREATMENT AND ACTION starts HAART – ATRIPLA - also effective against Hep B starts SEPTRIN PCP prophylaxis wife tests HIV –ve therefore no need to test child back pain likely mechanical

6 working with RESULTS AND RESPONSE July 2010 – CD4 up to 160 viral load down to tolerating treatment well very relieved GP did test

7 working with ONGOING RESULTS AND RESPONSE Sept. CD4 210 – stop septrin viral load 615 Oct. viral load 118, Hep B DNA <100, Jan 2011, CD4 360, V/L <50 Feels very well

8 working with SUMMARY Pt from high risk background very advanced HIV disease relatively asymptomatic - lucky responds well re HIV and Hep B - life saving wife negative – HIV prevention Could we have tested sooner?

9 working with PATIENT B 45 yr old male background - White UK Chef Lived in Bromley long time

10 working with PC and PMH Sore tongue ?OHL (Dec 2010) Whitlow and skin probs (Dec 2010) Crohn’s (09) URTIs (04/05)

11 working with RESULTS AND ACTION HIV test +ve, referred GUM (Jan) confirmatory test +ve Gay man – never tested before - didn’t perceive at risk Partner tested HIV +ve

12 working with RESULTS AND ACTION CD4 210, v/l o/e mouth sore, fungal skin rashes fatigue and diarrhoea on/off mouth swab - candida STI screen NAD

13 working with TREATMENT AND RESPONSE HAART – Truvada efavirenz (Feb) fluconazole and topical daktakort CD4 280, V/L 144 (March) mouth and skin better CD4 270, V/L <50 (April) well and grateful to GP

14 working with SUMMARY Pt from high risk background symptomatic – advanced disease Good therapy response– life saving prevention – education about HIV and future safer sex Could we have tested him sooner?


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