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

2. HIV CASE PRESENTATIONS David Fletcher MD FRCPC

3. CASE 1 63 yo man HIV+ since 1984 CD4 nadir 200/12% Non smoker No hypertension/Diabetes/Family history of heart disease

4. CASE 1 DATEREGIMENCD4Viral Load 1987-91AZT200-400------------- 1991-95AZT/ddC400------------- 1995-96AZT/3TC400------------- 1996-97AZT/3TC/SQV600------------- 1997d4T/3TC/SQV700600 Antiviral History

5. CASE 1 DATEREGIMENCD4VL 1997-00d4T/ddI/NFV/DLV/SQV700<500/<50 2001AZT/ddI/3TC/RTV/LPV/ APV/DLV 300-400<50 20043TC/T20/RTV/LPV/APV/ DLV 400<50 2008-133TC/RTV/DRV/RGV/ETR /MVC 600-700<40 Antiviral History

6. CASE 1 DATECHOLHDLLDLTGApo BLIPID MEDS 19995.380.902.773.03------------------- 20004.091.082.560.99--------ASA/FIBRATE 20013.721.262.291.26--------ASA/FIBRATE 20033.820.862.371.28--------ASA/FIBRATE/ HMG/FISH OIL 20053.931.261.692.310.93ASA/FIBRATE/ HMG/FISH OIL

7. CASE 1 DATECHOLHDLLDLTGApo BLIPID MEDS 20073.921.721.560.90--------ASA/FIBRATE/ HMG/FISH OIL 20094.471.241.751.50--------ASA/FIBRATE/ HMG/FISH OIL 20104.511.582.041.62--------ASA/FIBRATE/ HMG/FISH OIL 20114.321.311.411.680.76ASA/FIBRATE/ HMG/FISH OIL 20124.171.311.523.26--------ASA/FIBRATE/ HMG/FISH OIL

8. CASE 1 2003 Sudden visual field defect – Anterior ischemic optic neuropathy

9. CASE 1 2012 Exercises 5x/wk In latter part of fall 2012, noted new onset exertional angina Stress Echo – Normal LV function – Inferior wall dyskinesis with exercise

10. CASE 1 December 2012 Angiography