CASO CLINICO Il paziente naϊve ad alta viremia

Viremia: >500000 copies/ml CD4: 243 cells/µl Risk Factor MSM Clinical Case: ID 7200 Patient with HIV-1 CRF12_BF subtype Age 45 Sex M CDC stage B2 I Seropositivity January 2008 in out Feb-08 Apr-08 May-08 Jul-08 Oct-08 Jan-09 Apr-09 Jul-09 Jan-10 Apr-10 Aug-10 Nov-10 Mar-11 Jun-11 Nov-11 Mar-12 1.0 1.5 2.0 2.5 3.0 3.5 4.0 4.5 5.0 5.5 6.0 Viremia (log copies/ml) 50 100 150 200 250 300 350 400 450 500 550 600 650 700 750 800 850 900 CD4 cell count (cells/ul) >500000 cps/ml Undetectability threshold 6.5 GRT February 2008 PR: L10V RT: None Other pol mutations PR: K14KR, I15V, G17D, E35D, M36I, R41K, R57K, Q61N I93L RT: V35T, V60I, K122E, D123A, I135IT, I142IT, I178IM, I195IL, G196E, A272P, T286A, I293V, E297K On February 2008 Viremia: >500000 copies/ml CD4: 243 cells/µl Rapid achievement of virological response and maintenance of undetectability in patient with very high pre-HAART viremia FEB ‘08 – MAR ‘12 TDF+FTC, EFV

Clinical Case: ID 7200 Patient I Seropositivity January 2008 Risk Factor MSM Clinical Case: ID 7200 Patient with HIV-1 CRF12_BF subtype Age 45 Sex M CDC stage B2 I Seropositivity January 2008 Mutation scoring* for the protease PR  ATV/r  DRV/r  FPV/r  IDV/r  LPV/r  NFV  SQV/r  TPV/r  L10V 5 Total:  GRT March 2008 Mutation scoring* for the reverse transcriptase RT  3TC  ABC  AZT  D4T  DDI  FTC  TDF  EFV ETR NVP RPV Total:  GRT March 2008 * Stanford Algorithm (http:hivdb.stanford.edu) Susceptible virus