1 / 15

Early Treatment: cases

Early Treatment: cases. David Baker East Sydney Doctors. Ron – 2011. 34 year old gay male HIV +ve 2011 CD4 = 570, VL = 102 000 One partner who is HIV +ve Not wanting treatment Otherwise well. Ron – 2014. No regular follow-up Herpes zoster CD4 = 470 Starting ARVs. Greg - 2013.

fayola
Download Presentation

Early Treatment: cases

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Early Treatment:cases David Baker East Sydney Doctors

  2. Ron – 2011 • 34 year old gay male • HIV +ve 2011 • CD4 = 570, VL = 102 000 • One partner who is HIV +ve • Not wanting treatment • Otherwise well

  3. Ron – 2014 • No regular follow-up • Herpes zoster • CD4 = 470 • Starting ARVs

  4. Greg - 2013 • 57 year old gay male • HIV +ve 1997 • Long term HIV –ve partner • Reluctant patient – rarely attends • CD4 = 660 • VL undetectable

  5. Jack- 2014 • 62 year old heterosexual male • Long term HIV –ve partner • Otherwise well • CD4 = 718 • VL = 7800

  6. Jason • 32 year old gay male, single • HIV +ve 2 weeks ago • Has booked 5 month holiday starting in 3 weeks • CD4 = 521 • VL = 4500

  7. Peter • 33 year old gay male • HIV +ve 4 months ago in Melbourne • Moving to Sydney • Long term HIV –ve partner • CD4 = 789 • VL = 48000 • Wants trial of natural therapies

  8. Tim • 44 year old gay male • HIV +ve 2 years • Single, multiple partners • CD4 = 620 • VL = 89 000 • Weekend alcohol and crystal binges • Wants to sort out drug problem before starting treatment

  9. HIV case

  10. SR • 26 yr old male, FTE, stable accommodation, Brazilian with Australian residency • HIV positive Sept 2012 (HIV neg May 2012) • Admitted to SVH Aug 2012 with febrile illness but nil HIV test (? Sinusitis) • Possible rUPAI early Aug (2 x CMP in Ibeza) – states nil ejaculation “thought he was being careful”) • CD4 480, HIV VL 38,000

  11. SR • Repeat pathology Oct 2012 • CD4 556 (31%), VL 22,600 • Treatment options were actually discussed at this time but not interested as yet • Also not interested in further counselling / groups – worried about other people knowing about his diagnosis

  12. SR • Repeat pathology March 2013 • CD4 535 (21%), VL 63,000 • Seborrhoiec dermatitis, rosacea (Dermatology review) • Rectal and pharyngeal gonococcal PCR positive (states ‘brief’ rUPAI) • Anxious about physical appearance • Concerned he might have lymphadenopathy • Worried that all physical symptoms linked to HIV • Requests to commence treatment

  13. Issues ? Against • CD4 count above 500 (following initial count) • ? Young age and lifelong treatment (? wait a few years) ? Fully informed • ? Side effects (what key points to discuss) ? For • Recent STI demonstrates ongoing sexual risk - ? public health issue • Individual health benefits (? What to tell him)

  14. Alternatively • 26 yr old male, same results • Unemployed, Newstart • Currently ‘living with friends’ • Using $50 methamphetamine daily IV • Regular rUPAI

  15. For • Public health issues • ? Individual health benefits Against • Compliance and possible resistance • Financial

More Related