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Table 1 Summary of case scenarios

From: Prescribing and using self-injectable antiretrovirals: How concordant are physician and patient perspectives?

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
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