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Innovative Management Strategies for HIV: A Case Study of Lipohypertrophy Challenges

This case presentation explores the complexities of managing a 48-year-old HIV-positive male patient with a history of significant clinical changes over the years. Despite achieving adherence to treatment with a combination of medications (TDF/ABC/3TC/RTV/ATZ/EFV), the patient faces dissatisfaction due to increasing facial lipohypertrophy and dorsocervical fat pad accumulation. This presentation discusses potential treatment adjustments, including switching Tenofovir or Atazanavir, and deliberates on the best course of action based on desired outcomes and lab results.

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Innovative Management Strategies for HIV: A Case Study of Lipohypertrophy Challenges

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  1. VIRTUAL MEDZONE Your Resource for HIV Related Innovative Medical Communication

  2. HIV CASE PRESENTATIONS Colin Kovacs MD FRCPC David Fletcher MD FRCPC

  3. CASE 2 • 48 yo man • HIV+ 1990 • CD4 nadir 120/6% • No HIV viral load or genotype

  4. CASE 2

  5. CASE 2 GENOTYPE AUG/04

  6. CASE 2 2005 • TDF/ABC/3TC/RTV/ATZ/EFV initiated

  7. CASE 2

  8. CASE 2

  9. CASE 2 2010-2011 • Patient unhappy with increasing facial lipohypertrophy along with dorsocervical fat pad

  10. CASE 2 2010-2011 • Doctor unhappy with following lab results

  11. CASE 2 WHAT DO YOU DO? ….. ?Nothing ?Switch Tenofovir ?Switch Atazanavir ?Switch both… If so, to what?

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