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December 2014 NEWSLETTER
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2014
December
December 2014 Newsletter
GRAND ROUNDS
A 10 year old girl presented for HIV screening in view of mother having died with AIDS 7 years ago and younger brother being diagnosed with HIV presently. The father was screened for HIV ELISA and found to be HIV negative. The girl had pulmonary TB at the age of 5 years for which she was treated with antituberculous therapy (ATT) for 6 months. She was otherwise asymptomatic. She had been screened for HIV by ELISA at 2 years of age which was positive as per father. (However there was no report of test available). On examination, she had cervical lymphnodes (insignificant), hepatosplenomegaly and pallor. Other systems were normal. Her HIV ELISA test was done which was negative. However in view of her clinical findings and strong family history a repeat HIV ELISA test was done from another laboratory by another kit which was found to be positive. On enquiry with the first laboratory regarding the negative ELISA report, it was found that the child’s HIV ELISA was actually positive. However, another child with the same name had a negative HIV ELISA test and the technician had handed over the other child’s report without verifying the code. Thus the child was actually HIV infected.
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Question Of the Day
Q. I have a patient 14 years old boy on HAART therapy from his birth. Due to poor adherence he developed resistance to lamivudine, partialy to didanosine and abacavir and had changes in therapy several times: First therapy: retrovir 3TC, nelfinavir Second therapy {2 year of life} Zerit, Videx, Kaletra in 2008 Videx was withdrown so we gave him Stocrin instead Third therapy {ongoing} May 2011 Retrovir, Kaletra, Viread Now he want the single tablet therapy. My question is whether Atripla is appropriate for him_? He has M184V mutation, but I read that it may increase susceptibility to AZT, TDF and d4T. His current CD4 count is 528, mm3, Viraemia is undetectable { Less than 50 copies}. We have access to atazanavir or darunavir and truvada.
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HIV GRAND ROUNDS
A 32 years old HIV infected pregnant female (G2P2L1) presented at 36 weeks of pregnancy for deciding neonatal antiretroviral (ARV) prophylaxis. Her HIV viral load at 34 weeks of gestation was undetectable and she was on antiretroviral therapy (ART) consisting ....
HIV IN CHILDREN APPS