2019 Ryan White HIV/AIDS Program CLINICAL CONFERENCE

Case 7

• 55 yo man referred to you for evaluation • Diagnosed 18 years ago with HIV infection • Initial: HIV RNA 936,000c/ml CD4 count 70 cells/ul • Current: HIV RNA 85 c/ml (prior value 62 c/ml) CD4 count 525 cells/ul • Started on NEL/D4T/3TC; subsequently treated with • LOP-r / TDF/FTC, • EFV/ FTC/ TDF (fdc). • Now DTG / DRV/c / 3TC • No historical resistance tests are available

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ARS Question 10: Should you change ARV therapy now?

A. Yes

B. No

C. Not sure

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Virologic Responses on Antiretroviral Therapy Virologic Suppression

1,000,000

100,000

AntiretroviralTherapyStarted

1,000 10,000

10 100

50

1

0

4

8 12 16 20 24 28

HIV RNA (copies/mL)

Weeks

A confirmedHIVRNA level below the limit ofassaydetection (e.g., <48 copies/mL).

Source: 2016 DHHS Antiretroviral Therapy Guidelines. AIDS Info.

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