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CASE 2. 53 yo man HIV + 2006 CD4 340/16% (Nadir) VL 30,100 c/ml. CASE 2. BASELINE GENOTYPE OCT/06. CASE 2. April 2008 Abacavir /3TC/ Tenofovir /Ritonavir/ Lopinavir / Raltegravir /Maraviroc initiated as part of intensification study. CASE 2. CASE 2. March 2011
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CASE 2 • 53 yo man • HIV + 2006 • CD4 340/16% (Nadir) • VL 30,100 c/ml
CASE 2 BASELINE GENOTYPE OCT/06
CASE 2 April 2008 • Abacavir/3TC/Tenofovir/Ritonavir/ Lopinavir/Raltegravir/Maraviroc initiated as part of intensification study
CASE 2 • March 2011 • Regimen de-intensified to Truvada/Raltegravir as complex and VL=0 WHAT HAPPENED?
CASE 2 GENOTYPE OCT/2011
CASE 2 WHAT WOULD YOU DO ?
CASE 2 Sept/2011 • Told to stop all therapy x 3 months in order to repopulate with wild-type
CASE 2 Oct/2012-Jan/2012…No therapy • CD4 460/17%, 330/17% • VL 4851 c/ml, 3069 c/ml
CASE 2 • Jan/2012 • Reinitiated ABC/3TC/RTV/DRV/ETR/RGV instead of ABC/3TC/TNF/RTV/LOP/RGV/MVC Would you de-intensify?