1 / 5

Case 4: 65-year-old Man Newly Diagnosed, Has Other Health Issues

Case 4: 65-year-old Man Newly Diagnosed, Has Other Health Issues. Paul E. Sax, MD. Clinical Director, Division of Infectious Diseases Brigham and Women’s Hospital Professor of Medicine Harvard Medical School Boston, MA. 65-year-old Man Newly Diagnosed, Has Other Health Issues.

koren
Download Presentation

Case 4: 65-year-old Man Newly Diagnosed, Has Other Health Issues

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. Case 4: 65-year-old Man Newly Diagnosed, Has Other Health Issues Paul E. Sax, MD Clinical Director, Division of Infectious Diseases Brigham and Women’s Hospital Professor of Medicine Harvard Medical School Boston, MA

  2. 65-year-old Man Newly Diagnosed, Has Other Health Issues • 65-year-old man is newly diagnosed with HIV infection • Celebrated retirement with prolonged trip to Brazil • During the trip, he had multiple episodes of unprotected sex with both men and women • After a lengthy "flu" (3 months ago) that in hindsight was likely acute HIV infection, he is found to be HIV-antibody positive

  3. 65-year-old Man Newly Diagnosed, Has Other Health Issues Physical exam: • BP = 160/110 • Otherwise normal • CD4 cell count = 310 • HIV RNA = 144,000 • Genotype shows no resistance Past medical history: • Notable for difficult-to-control hypertension requiring amlodipine, lisinopril, and metoprolol • Diabetes, treated with glipizide and metformin • Other medications include simvastatin and sildenafil • Renal function is normal, and he has no proteinuria

  4. 65-year-old Man Newly Diagnosed, Has Other Health Issues Would you start ART now or wait another 2 to 3 months since HIV has been acquired recently and perhaps he has not reached his “set point”? • Start now • Wait 2-3 months • Wait longer

  5. 65-year-old Man Newly Diagnosed, Has Other Health Issues Question to consider: What is the optimal initial regimen in a patient with several cardiovascular and renal risk factors?

More Related