Table 1 Summary of case scenarios
Two scenarios were used to evaluated physicians' prescribing intent for patients who are clear candidates for receiving a new ARV class to achieve treatment goals as recommended by international guidelines |
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Case 1: Ex-IVD user |
   • 46-Year-old white heterosexual male infected with HIV through IVD use and diagnosed in 1989 |
   • Peak VL 100 000 copies/mL, CD4 nadir 40 cells/mm3; current VL 20 000 copies/mL, CD4 145 cells/mm3 (declined 30 cells/mm3 since previous visit) |
   • Treatment history includes ZDV, d4T, ddI, ddC, EFV, NVP, SQV, IDV, SQV/r, NFV, LPV/r, and IDV/r (severe reactions with NNRTIs and developed K103N mutation; gastrointestinal distress with many PIs, particularly LPV/r; patient also suffers from severe lipodystrophy) |
Two regimen options recommended by HIV physician panel: |
   • Option X: TPV/r + enfuvirtide + 3TC + TDF |
   • Option P: ATV/r/SQV + 3TC + TDF |
Case 2: Patient with history of nonadherence |
   • 42-Year-old black African female diagnosed with AIDS (pneumocystis pneumonia) in 2002 |
   • At diagnosis, VL 100 000 copies/mL and CD4 40 cells/mm3; current VL 2000 copies/mL and CD4 200 cells/mm3 (210 cells/mm3 at previous visit) |
   • Treatment history includes ZDV, ABC, TDF, 3TC, FTC, EFV, ATV/r, and LPV/r |
   • Resistance profile includes 41L, 215Y, 184V, and 103N |
   • Nonadherence associated with gastrointestinal side effects, failure to take drugs on days that patient feels healthy and running out of drugs during an extended trip to Africa |
Two regimen options recommended by HIV physician panel: |
   • Option X: TPV/r + enfuvirtide + 3TC + TDF |
   • Option P: FPV/r/SQV + 3TC + TDF |