1. VIRTUAL MEDZONE Your Resource for HIV Related Innovative Medical Communication

2. HIV CASE PRESENTATIONS Anita Rachlis MD FRCPC Ken Logue MD David Fletcher MD FRCPC

3. CASE 1 49 yo man HIV+ 1986 CD4 400 Asymptomatic

4. CASE 1 DATEREGIMENCD4VL 1996AZT/3TC/INDINAVIR120? 1996-99D4T/3TC/RTV/SQV200/10%13,000- 32000

5. CASE 1 DATEREGIMENCD4VL 1996-99D4T/3TC/ RTV/SQV 200/10%13000- 32000 1999- 2003 ABC/DDI/ RTV/LPV/NVP 200-350/14%1000- 3000

6. CASE 1 GENOTYPE MAR/03

7. CASE 1 DATEREGIMENCD4VL 1999- 2003 ABC/DDI/ RTV/LPV/NVP 200-350/14%1000- 3000 2003-08ABC/DDI/RTV/ LPV/APV/ NVP/T20 350-530/16%<50 2008-11ABC/3TC/RTV/ DRV/RGV/NVP (bid) 370-420/18%<50

8. 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?

9. CASE 1 GENOTYPE MAR/03

10. 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

11. CASE 1 49 yo man HIV+ 1986 CD4 400 Asymptomatic

12. CASE 1 49 yo man HIV+ 1986 CD4 400 Asymptomatic

13. CASE 1 49 yo man HIV+ 1986 CD4 400 Asymptomatic