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Innovative HIV Case Presentation: 66-Year-Old Woman with Asymptomatic HIV and Complications

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This case presentation by Dr. Mike Silverman, Dr. Jason Brunetta, and Dr. David Fletcher discusses a 66-year-old woman diagnosed with HIV in 1996. Initially asymptomatic, she has a history of hypertension and no medications as per her request. In late 2010, she presents with increased eosinophilic folliculitis, oral pain, and significant weight loss. Examination reveals severe oral candidiasis, and lab tests show declining hemoglobin levels and low CD4 count, raising concerns about her immune status and the implications of her HIV management.

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Innovative HIV Case Presentation: 66-Year-Old Woman with Asymptomatic HIV and Complications

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Presentation Transcript

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

  2. HIV CASE PRESENTATIONS Mike Silverman MD FRCPC Jason Brunetta MD CCFP David Fletcher MD FRCPC

  3. CASE 1 66 yr old woman / HIV+ 1996 /Asymptomatic

  4. CASE 1

  5. CASE 1

  6. CASE 1 Other Issues • Hypertension 180/100 x 8 yrs • No Meds as per patient request • 2D echo x2 over 5 yrs • Normal function • Normal LV Mass

  7. CASE 1 Late 2010 • Increased eosinophillic folliculitis of skin • Tongue/oral pain/burning – denies dysphagia or odynophagia • 10 lb weight loss • O/E – severe oral candidiasis

  8. CASE 1 Late 2010 • Hb 140 → 111 (2009-2010) • CD4 60 • %CD4 12 • CD4/CD8 0.2 • HIV VL 295,251 WHAT HAPPENED HERE ???

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