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CASE 5

CASE 5. 52 yo man HIV+ since 1989 CD4 nadir 110. CASE 5. MAR 2010-JULY 2013 CD4 110-130 Does NOT and has NEVER wanted HIV meds despite my best efforts and warnings. CASE 5. NOV-DEC 2013

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CASE 5

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  1. CASE 5 • 52 yo man • HIV+ since 1989 • CD4 nadir 110

  2. CASE 5 MAR 2010-JULY 2013 • CD4 110-130 • Does NOT and has NEVER wanted HIV meds despite my best efforts and warnings

  3. CASE 5 NOV-DEC 2013 • Develops cough/soboe…non specific interstitial pneumonitis…felt to be hypersensitivity based • Worked up by respirologist and bronchoscopy/BAL performed to r/o opportunistic infection

  4. CASE 5 NOV-DEC 2013 • Treated with high dose steroids with great effect from a respiratorystandpoint

  5. CASE 5 DEC 2013-JAN 2014 • Develops headaches/fever/decreased LOC and experiences a stroke • Diagnosed with Cryptococcal meningitis and treated with Amphotericin followed by Fluconazole with effect…steroids stopped

  6. CASE 5 FEB 2014 • Much improved and now asymptomatic with no stroke sequelae • Still not ready to initiate ARVS but is ready now to consider them

  7. CASE 5 FEB 2014 • Wants to see bloodworknow that he is better and off steroids • CD4 120 • Wants ARV recommendations… baseline genotype done

  8. CASE 1 BASELINE GENOTYPE FEB/2014

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