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

2. HIV CASE PRESENTATIONS Mike Silverman MD FRCPC Jason Brunetta MD CCFP David Fletcher MD FRCPC

3. CASE 1 66 yr old woman / HIV + 1996 /Asymptomatic NO THERAPY DATECD4% CD4CD4/CD8VL 1997440350.983850 1999620310.649080 2001242170.337569 2001319140.263483

4. CASE 1 NO THERAPY DATECD4% CD4CD4/CD8VL 2002216140.215012 2003400190.327788 2004420220.486569 2005410230.476476

5. CASE 1 NO THERAPY DATECD4% CD4CD4/CD8VL 2005450280.619286 2006800330.745563 2007860280.684013 2008350330.783326 2009630350.829449

6. CASE 1 Other Issues Hypertension 180/100 x 8 yrs – No Meds as per patient request 2D echo x2 over 5 yrs – Normal function – Normal LV Mass

7. CASE 1 Late 2010 Increased eosinophillic folliculitis of skin Tongue/oral pain/burning – denies dysphagia or odynophagia 10 lb weight loss O/E – severe oral candidiasis

8. CASE 1 Late 2010 Hb 140 → 111 (2009-2010) CD4 60 %CD4 12 CD4/CD8 0.2 HIV VL 295,251 WHAT HAPPENED HERE ???