CASE 4 53 yo man HIV+ since 1989 CD4 nadir 220. CASE 4 DATEREGIMENCREATININE 1990AZT100 1994AZT/DDI99 1998AZT/3TC/IDV108 1999AZT/3TC/NFV95 2004TDF/AZT/3TC/NFV102.

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Presentation transcript:

CASE 4 53 yo man HIV+ since 1989 CD4 nadir 220

CASE 4 DATEREGIMENCREATININE 1990AZT AZT/DDI AZT/3TC/IDV AZT/3TC/NFV TDF/AZT/3TC/NFV TDF/AZT/3TC/RTV/LPVr108

CASE 4 Longstanding chronic active (E ag Positive) Hepatitis B/Cirrhosis 3TC resistant

CASE 4 DATEARV REGIMEN Creat.ALB/CreatU/A Random Ur. Protein TDF/AZT/3TC/R TV/LPVr 108-(-)- 2010“1117.4(-)- 02/2011“119-Tr. Protein- 11/2011“14914Tr. Protein- No obvious reversible inciting cause

CASE 4 DATECreat.ALB/CreatU/AR. U. Protein 11/ Tr. Protein- 02/ <2-<0.04 Switched to ABC/3TC/AZT/RTV/LPV in 12/11  AST/ALT +  HBV DNA !!!!!

CASE 4 DATECreat.ALB/CreatU/AR. U. Protein 04/201294<2-< / / >1g/L / g/L- Restarted TDF/3TC/AZT/RTV/LPV post 04/12 labs

CASE 4 DATECreat.ALB/CreatU/AR. U. Protein 07/ g/L- 08/ g/L / g/L0.998 TDF DOSED TO EVERY OTHER DAY AND RTV/LPV SWITCHED TO RTV/DRV in 7/12 Normal liver enzymes HBVDNA (-)

CASE 4 DATECreat.ALB/CreatU/AR. U. Protein 08/ g/L / g/L / g/L / / g/L / g/L0.589 SWITCHED TO AZT/3TC/ETR/RGV/TDF eod 10/12 NORMAL LIVER ENZYMES HBV DNA (-)