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CASE 3

CASE 3. 56 yo man HIV + 2006 CD4 310 VL 69,241 c/ml Asymptomatic Baseline genotype…no mutations. CASE 3. TDF/FTC/EFV initiated V ivid dreams initially for first month At 12 months, lipids an issue for which Rosuvastatin is initiated Otherwise well, no problems. CASE 3.

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CASE 3

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  1. CASE 3 • 56 yo man • HIV + 2006 • CD4 310 • VL 69,241 c/ml • Asymptomatic • Baseline genotype…no mutations

  2. CASE 3 TDF/FTC/EFV initiated • Vivid dreams initially for first month • At 12 months, lipids an issue for which Rosuvastatin is initiated • Otherwise well, no problems

  3. CASE 3 TDF/FTC/EFV • At 24 months, lipids under good control • Issues with sleep with diffculty falling asleep and early awakening • No concurrent depressive/anxiety related issues

  4. CASE 3 TDF/FTC/EFV • At 27 months, sleep worsening, daytime somnolence, profound fatigue • Stress at work and home due to poor performance/ chronic lateness, agitation and dysphoria

  5. CASE 3 TDF/FTC/EFV • Patient asking for an antiretroviral switch as his friends told him they had the same issues with TDF/FTC/EFV What would you do?

  6. CASE 3 TDF/FTC/EVF continues: • Rosuvastatin held and sleep improves back to normal • Daytime somnolence/fatigue/agitation/ dysphoria and poor work/home performance disappears concomitantly

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