HUMAN IMMUNODEFICIENCY VIRUS

CASE STUDY CHAPTER 49, HUMAN IMMUNODEFICIENCY VIRUS A.P. is a 36-year-old woman who was diagnosed with HIV DIAGNOSIS: ASYMPTOMATIC HIV INFECTION infection 2 weeks ago at a community outreach clinic. She has been feeling well for the past 2 years, and she maintains 1. List specific goals for treatment for this patient. a healthy, active lifestyle by exercising three to four times a 2. What drug therapy would you prescribe? Why? week and eating a balanced diet. Her medications include a 3. What are the parameters for monitoring success of the multiple vitamin and occasional antacids for heartburn, and therapy? she does not consistently use birth control methods. She has 4. Discuss specific patient education based on the pre- never received ART. She comes to your office for an initial scribed therapy. physical exam and blood work in preparation for treatment 5. List one or two adverse reactions for the selected agents initiation. The physical examination is unremarkable, and that would cause you to change therapy. the laboratory results are as follows: 6. What would be the choice for the second-line therapy? 7. What over-the-counter and/or alternative medications Electrolytes, serum creatinine, liver function tests: within would be appropriate for A.P.? normal limits 8. What dietary and lifestyle changes should be recom- Complete blood count with differential: within normal mended for this patient? limits 9. Describe one or two drug-drug or drug-food interac- CD4+ T-cell count: 400 cells/mm’ tions for the selected agents. Viral load: 1 10,000 copies/ml Genotype: No resistance mutations detected