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Clinical case 19

Clinical case 19. Lin, I-Yao (Sally). Case 19 Having been confined in the hospital for almost a month due recurrent pneumonia , Mr. XXX, 42 y/o, married, a dance instructor in Japan for almost 10 years was diagnosed to have AIDS.

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Clinical case 19

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  1. Clinical case 19 Lin, I-Yao (Sally)

  2. Case 19 Having been confined in the hospital for almost a month due recurrent pneumonia , Mr. XXX, 42 y/o, married, a dance instructor in Japan for almost 10 years was diagnosed to have AIDS. 1.Aside from the antibacterial combination given how are you going to manage your patient using your Reverse Transcriptase inhibitor? 2.What examination/s should you request before and during the treatment? And what would you watch for? 3.In case there is a significant clinical or immunological deterioration during you RT inhibitor treatment. What will be your next drug regimen?

  3. Non-nucleoside reverse transcriptase (NNRITs) inhibit HIV by binding noncompetitively to the reverse transcriptase. A single dosage of nevirapine at the time of labor has been shown to decrease perinatal transmission of the virus. Side effects of NNRITs include rash, increased AST and ALT, and Steven-Johnson syndrome (more likely with nevirapine) • Nucleoside analog reverse transcriptase (NRITs) constrain HIV replication by incorporating into the elongating strand of DNA, causing chain termination. All nucleoside analogs have been associated with lactic acidosis, presumably related to mitochondrial toxicity.

  4. reverse transcriptase - the enzyme produced by HIV and other retroviruses that allows them to synthesize DNA from their RNA.

  5. Laboratory findings with HIV infection

  6. Laboratory findings with HIV infection

  7. Single or Combine drug for treatment

  8. HIV resistance testing (during the treatment) • HIV resistance testing is done using two different types of assays: genotypic, in which the reverse transcriptase and the polymerase genes are sequenced using different techniques, and phenotypic, in which the behavior of HIV in vitro in the presence of antiretroviral drugs is examined. Results of resistance testing can be used to guid ART.

  9. Combination therapy (three drug used) ↓ Two nucleoside reverse transcriptase inhibitors + A non-nucleoside reverse transcriptase inhibitor or One protease inhibitor

  10. Thank you

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